Individual provider Active NPI

Maureen Ambinder-Knice, APRN BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1043346448
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00117300 Issued in NJ
Practice address
550 Broad St Ste 606
Newark, NJ 07102-4537
Phone
(201) 822-1161
Fax
(877) 485-8918
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00117300 NJ Primary

Addresses

Primary practice location

550 Broad St Ste 606
Newark, NJ 07102-4537

Mailing address

917 Carleton Rd
Westfield, NJ 07090-1689
Phone (908) 654-0369

Other practice location 1

260 Broadway Fl 2
Newark, NJ 07104-3906
Phone (973) 482-2774 ext. 120

Other identifiers 1

IdentifierTypeStateIssuer
0321435MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170426001219 NJ Practitioner - Nurse Practitioner 3870870033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
JLS Medical PCGroup PAC ID 7719342005, 53 clinicians

Practice addresses (Care Compare)

550 Broad St
Suite 606
Newark, NJ 07102-4537
Phone (201) 822-1161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00117300NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
JLS Medical PC Psychiatric/Mental Health CurrentSince Jul 17, 2023 Accepting new patients
Bancroft, a New Jersey Nonprofit Corporation PastSince Jul 17, 2023 Accepting new patients

Locations

550 Broad St
Ste 606
Newark, NJ 07102
Phone (425) 458-8525

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1043346448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 CARLETON RD",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070901689",
            "telephone_number": "908-654-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 BROAD ST STE 606",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071024537",
            "telephone_number": "201-822-1161",
            "fax_number": "877-485-8918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "260 Broadway Fl 2",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071043906",
            "country_code": "US",
            "telephone_number": "973-482-2774 x120",
            "fax_number": "973-482-2870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMBINDER-KNICE",
        "first_name": "MAUREEN",
        "name_prefix": "Ms.",
        "credential": "APRN BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00117300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0321435",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.