Individual provider Active NPI

Ogechi Enwereji, FNP

  • Nurse Practitioner
  • Summit, NJ
National Provider Identifier
1114616059
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ01482800 Issued in NJ
Practice address
99 Beauvoir Ave
Summit, NJ 07901-3533
Phone
(908) 522-2000
NPI assigned
May 5, 2023
Last updated
Sep 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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 26NJ01482800 NJ
Nurse Practitioner 363L00000X 26NJ01482800 NJ Primary

Addresses

Primary practice location

99 Beauvoir Ave
Summit, NJ 07901-3533

Mailing address

650 Stonetown Rd
Ringwood, NJ 07456-1322

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
I20230809000525 NJ Practitioner - Nurse Practitioner 8022470004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gold Standard Medical Group PCGroup PAC ID 2961762554, 32 clinicians

Practice addresses (Care Compare)

992 Clifton Ave
Clifton, NJ 07013-3502
Phone (201) 839-5016

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01482800NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gold Standard Medical Group PC CurrentSince May 24, 2025 Accepting new patients
Emergency Physician Associates of North Jersey P C CurrentSince Sep 1, 2023 Accepting new patients
Sureguard LLC CurrentSince Jun 1, 2024 Accepting new patients
Sureguard LLC CurrentSince Jun 1, 2024 Accepting new patients

Locations

992 Clifton Ave
Clifton, NJ 07013
Phone (201) 839-5016

1 Hospital Plz
Old Bridge, NJ 08857
Phone (732) 324-4158

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

Interoperability endpoints

  • Direct secure messaging: oenwerejiklein508199@direct.ahsys.org

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, 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": "1683244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1114616059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 STONETOWN RD",
            "city": "RINGWOOD",
            "state": "NJ",
            "postal_code": "074561322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 BEAUVOIR AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013533",
            "telephone_number": "908-522-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENWEREJI",
        "first_name": "OGECHI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-05",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01482800",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01482800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.