Kamsiyochukwu Obu

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ15276900 Issued in NJ

Practice address

1140 Burnt Tavern Rd Ste 1a
Brick, NJ 08724-1496

Phone

(908) 417-0632

NPI assigned

Feb 19, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Grace Behavioral Health ServicesGroup PAC ID 9931513223, 2 clinicians

Sage Wellness Center LLCGroup PAC ID 8729386370, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Grace Behavioral Health Services

  • Psychiatric/Mental Health Nurse Practitioner
  • Brick, NJ
  • NPI 1437766375
  Medicare reassignment Care Compare group NPD
• Sage Wellness Center LLC

  • Clinical Social Worker
  • Toms River, NJ
  • NPI 1669837811
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1104621416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 BURNT TAVERN RD STE 1A",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087241496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 BURNT TAVERN RD STE 1A",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087241496",
            "telephone_number": "908-417-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBU",
        "first_name": "KAMSIYOCHUKWU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15276900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Nydam, LPC
• Patrick J. O'Connor Jr., D.O.
• Kaitlyn O'Prandy
• Shannon O'Regan, BCBA
• Obanta Health Systems LLC
• Ocean Allergy Education and Research Center, LLC
• Ocean Allergy Partners, LLC
• Ocean Angels LLC Dba Visiting Angels of Toms River
• Ocean Biblical Counseling Center LLC
• Ocean Care & Staffing Inc. (Right at Home)

• Psychiatric/Mental Health Nurse Practitioner in Brick, NJ
• Providers in Brick, 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 Feb 19, 2025; 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.