Antonio Caraballo

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ15349700 Issued in NJ

Practice address

550 Mayor Gibson Blvd Ste 606
Newark, NJ 07102-4537

Phone

(201) 822-1161

NPI assigned

Apr 22, 2025

Last updated

Oct 7, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, PA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Senacare LLCGroup PAC ID 6103257571, shared by 2 NPIs, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• JLS Medical PC

  dba Wellbrook Health

  • Psychiatry Physician
  • Newark, NJ
  • NPI 1164007043

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Senacare, LLC

  • Internal Medicine Physician
  • Mullica Hill, NJ
  • NPI 1104447127
  Medicare reassignment NPD
• Senacare, LLC

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1023989837
  Medicare reassignment NPD
• Bancroft, a New Jersey Nonprofit Corporation

  • Rehabilitation Clinic/Center
  • Cherry Hill, NJ
  • NPI 1720121106
  NPD (past)

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1063209229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 S LEE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191484105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MAYOR GIBSON BLVD STE 606",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071024537",
            "telephone_number": "201-822-1161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "618 W Lehigh Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191332227",
            "country_code": "US",
            "telephone_number": "215-229-8857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARABALLO",
        "first_name": "ANTONIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-22",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP032747",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15349700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Huy Anh Cao, MD
• Vincent Capalbo, MD
• Isabel Susana Caparros
• Nicholas Capobianco, R.PH.
• Mary Caputo, CRNA
• Nicole Theresa Caragian, PNP
• Christian Caravaglia, MD
• Frank Caravella Jr.
• Elizabeth Da Silva Cardoso, PH.D
• Lucio A Cardoso, MD

• Psychiatric/Mental Health Nurse Practitioner in Newark, NJ
• Providers in Newark, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.