Individual provider Active NPI

Sophia Yanikah Bernard, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Teaneck, NJ
National Provider Identifier
1073276804
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01167200 Issued in NJ
Practice address
42 Van Buskirk Rd
Teaneck, NJ 07666-6210
Phone
(551) 285-8524
NPI assigned
Oct 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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 26NJ01167200 NJ Primary

Addresses

Primary practice location

42 Van Buskirk Rd
Teaneck, NJ 07666-6210

Mailing address

42 Van Buskirk Rd
Teaneck, NJ 07666-6210
Phone (551) 285-8524

Other practice location 1

51 JFK Pkwy Fl 1
Short Hills, NJ 07078-2713
Phone (917) 582-6622

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
I20220201002237 NJ Practitioner - Nurse Practitioner 3072906783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nynj Psychiatric Associates LLCGroup PAC ID 2961689989, 38 clinicians

Practice addresses (Care Compare)

51 JFK Pkwy
Short Hills, NJ 07078-2704
Phone (917) 582-6622

Hospital & facility affiliations

  • Bergen New Bridge Medical Center Hospital, Paramus, NJ, CCN 310058

Merit-based Incentive Payment System (MIPS)

Final score
87.66 of 100Reported as group
Quality
74.82
Improvement activities
40
Cost
71.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01167200NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nynj Psychiatric Associates LLC CurrentSince Dec 22, 2021 Accepting new patients

Locations

395 Grand St
Jersey City, NJ 07302
Phone (201) 915-2600

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1073276804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 VAN BUSKIRK RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076666210",
            "telephone_number": "551-285-8524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 VAN BUSKIRK RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076666210",
            "telephone_number": "551-285-8524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 JFK Pkwy Fl 1",
            "address_purpose": "LOCATION",
            "city": "Short Hills",
            "state": "NJ",
            "postal_code": "070782713",
            "country_code": "US",
            "telephone_number": "917-582-6622",
            "fax_number": "888-974-2142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERNARD",
        "first_name": "SOPHIA",
        "middle_name": "YANIKAH",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2022-12-09",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01167200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.