Individual provider Active NPI

Chelsea Elizabeth Earley

  • Neurology with Special Qualifications in Child Neurology Physician
  • New York, NY
National Provider Identifier
1043715790
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
25MA12326600 Issued in NJ
Practice address
3959 Broadway
New York, NY 10032-1559
Phone
(212) 305-2500
NPI assigned
Mar 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 25MA12326600 NJ Primary

Addresses

Primary practice location

3959 Broadway
New York, NY 10032-1559

Mailing address

3959 Broadway
New York, NY 10032-1559

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240916002540 NJ Practitioner - Neurology 1850832015 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA12326600NJMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Epilepsy & Neurophysiology Medical Consultants PA Neurology With Special Qualifications in Child Neurology CurrentSince Oct 1, 2024 Accepting new patients
Epilepsy & Neurophysiology Medical Consultants, PA Neurology With Special Qualifications in Child Neurology CurrentSince Oct 1, 2024 Accepting new patients

Locations

20 Prospect Ave
Ste 800
Hackensack, NJ 07601
Phone (201) 343-6676

377 Jersey Ave
Ste 440
Jersey City, NJ 07302
Phone (201) 289-5551

200 S Orange Ave
Ste 275
Livingston, NJ 07039
Phone (732) 235-6333

310 Madison Ave
Ste 302
Morristown, NJ 07960
Phone (973) 695-8033

303 George St
Ste 420
New Brunswick, NJ 08901
Phone (732) 828-1373

90 Bergen St
Ste 4100
Newark, NJ 07103
Phone (201) 996-3205

401 Hamburg Tpke
Ste 205
Wayne, NJ 07470
Phone (201) 996-3205

333 Westchester Ave
Ste E104
White Plains, NY 10604
Phone (914) 428-9213

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": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1043715790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100321559",
            "telephone_number": "212-305-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLEY",
        "first_name": "CHELSEA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NJ",
            "license": "25MA12326600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.