Melissa Sue Evans, APN-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

26NJ00553200 Issued in NJ

Practice address

125 Chubb Ave
Lyndhurst, NJ 07071-3504

Phone

(201) 559-7600

NPI assigned

Feb 18, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Medical Service Professionals of NJ LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lyndhurst, NJ
  • NPI 1972044923
  Medicare reassignment
• New Jersey Post Acute Medical Services 1 PA

  • Hospitalist Physician
  • Red Bank, NJ
  • NPI 1578092391
  NPD (past)

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1124419726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 AVENUE B",
            "city": "HELMETTA",
            "state": "NJ",
            "postal_code": "088281234",
            "telephone_number": "908-705-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CHUBB AVE",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070713504",
            "telephone_number": "201-559-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "MELISSA",
        "middle_name": "SUE",
        "credential": "APN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-18",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00553200",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ00553200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING,ADVANCED PRACTICE NURSE",
            "identifier": "26 NJ00553200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elite Anesthesia, LLC
• Elite Psychiatry, LLC
• Joann Elliott, LPC
• Marc Elqumos
• Kurt Michael Espiritu, PT, DPT
• Family Neurology & Rehab Center LLC
• Gerard Louis Faugno, MD
• Laura Maria Feliz Macario, LMSW
• Nickolas Fiallos
• First Care Medical Group Inc

• Primary Care Nurse Practitioner in Lyndhurst, NJ
• Providers in Lyndhurst, NJ by specialty
• Primary Care Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.