Individual provider Active NPI

Ebiaredo Alofe, NP

  • Psychiatric/Mental Health Registered Nurse
  • Union, NJ
National Provider Identifier
1043859499
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
26NR09618800 Issued in NJ
Practice address
704 Garden St
Union, NJ 07083-6642
Phone
(908) 472-8042
NPI assigned
Jan 2, 2020
Last updated
Jan 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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 Registered Nurse 163WP0808X 26NR09618800 NJ Primary

Addresses

Primary practice location

704 Garden St
Union, NJ 07083-6642

Mailing address

704 Garden St
Union, NJ 07083-6642
Phone (908) 472-8042

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
I20200707000750 NJ Practitioner - Nurse Practitioner 9931522125 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jersey Behavioral Care LLCGroup PAC ID 4183992142, 11 clinicians

Practice addresses (Care Compare)

220 Davidson Ave
Suite 306
Somerset, NJ 08873-4144
Phone (732) 997-0707

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR09618800NJMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Jersey Behavioral Care LLC CurrentSince Jun 1, 2020 Accepting new patients
State of New Jersey Omb Centralized Payroll CurrentSince Oct 4, 2021 Accepting new patients
Jersey Behavioral Care LLC CurrentSince Jun 1, 2020 Accepting new patients
Jersey Behavioral Care LLC Past Accepting new patients

Locations

59 Koch Ave
Morris Plains, NJ 07950
Phone (973) 889-4390

220 Davidson Ave
Ste 306
Somerset, NJ 08873
Phone (732) 997-0707

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJCDD/Endpoint/IHJCDD

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1043859499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 GARDEN ST",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070836642",
            "telephone_number": "908-472-8042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 GARDEN ST",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070836642",
            "telephone_number": "908-472-8042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALOFE",
        "first_name": "EBIAREDO",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NR09618800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.