Individual provider Active NPI

Cassandra Nunez, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Evesham, NJ
National Provider Identifier
1053958140
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00996200 Issued in NJ
Practice address
777 Route 70 E Ste G101
Evesham, NJ 08053-2548
Phone
(856) 818-4020
NPI assigned
Dec 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00996200 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00996200 NJ Primary

Addresses

Primary practice location

777 Route 70 E Ste G101
Evesham, NJ 08053-2548

Mailing address

180 Talmadge Rd # 822
Edison, NJ 08817-2860
Phone (973) 866-9387

Other practice location 1

111 Lexington Ave
Passaic, NJ 07055-5246
Phone (973) 471-8006

Other practice location 2

14 Ridgedale Ave
Cedar Knolls, NJ 07927-1106
Phone (973) 295-6335 ext. 97329

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
I20200312000194 NJ Practitioner - Nurse Practitioner 2163850892 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vita Nova Sana NP in Psychiatry Family CurrentSince Jun 2, 2024 Accepting new patients
Mental Health Clinic of Passaic Inc CurrentSince Feb 1, 2021 Accepting new patients
NJ Memory and Behavioral Care CurrentSince Jan 26, 2020 Accepting new patients
Regional NP in Psychiatry Past Accepting new patients

Locations

14 Ridgedale Ave
Ste 103
Cedar Knolls, NJ 07927
Phone (973) 295-6335

180 Talmadge Rd
#822
Edison, NJ 08817
Phone (646) 847-8654

111 Lexington Ave
Passaic, NJ 07055
Phone (973) 471-8006

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/mhcp/r4/

Organizations & group practices 4

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": "1575763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1053958140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 TALMADGE RD # 822",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088172860",
            "telephone_number": "973-866-9387",
            "fax_number": "973-604-4174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 ROUTE 70 E STE G101",
            "city": "EVESHAM",
            "state": "NJ",
            "postal_code": "080532548",
            "telephone_number": "856-818-4020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Lexington Ave",
            "address_purpose": "LOCATION",
            "city": "Passaic",
            "state": "NJ",
            "postal_code": "070555246",
            "country_code": "US",
            "telephone_number": "973-471-8006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14 Ridgedale Ave",
            "address_purpose": "LOCATION",
            "city": "Cedar Knolls",
            "state": "NJ",
            "postal_code": "079271106",
            "country_code": "US",
            "telephone_number": "973-295-6335 x97329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NUNEZ",
        "first_name": "CASSANDRA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-08",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00996200",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00996200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evesham, NJ

Sources for this page

Verify at the official NPI Registry.