Dominique Pelote, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ14854900 Issued in NJ

Practice address

286 Hawthorne St
Marlton, NJ 08053-2013

Phone

(917) 204-2763

NPI assigned

Jul 5, 2023

Last updated

Jul 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Rutgers New Jersey Medical School, 2022

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Mind Your MindGroup PAC ID 6002242690, 22 clinicians

Moonshot Psychiatric Nurse Practitioner PCGroup PAC ID 9335589696, 79 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.

• Mind Your Mind

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hamilton, NJ
  • NPI 1053955096
  Medicare reassignment Care Compare group NPD
• Moonshot Psychiatric Nurse Practitioner PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Seattle, WA
  • NPI 1669158879

  NJ

  Medicare reassignment Care Compare group NPD
• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  NJ

  Medicare reassignment NPD
• Lifebulb LLC

  • Mental Health Counselor
  • Toms River, NJ
  • NPI 1699491464
  NPD (past)

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1154009678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 HAWTHORNE ST",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532013",
            "telephone_number": "917-204-2763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 HAWTHORNE ST",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532013",
            "telephone_number": "917-204-2763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELOTE",
        "first_name": "DOMINIQUE",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ14854900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peds Purpose LLC
• Jennifer Peelman, LCSW
• Diane Peer, APN
• Julia Nicole Pellegrino
• Nicole Pelliciari, BCBA
• Chaliyah Penick, M.AC., L.AC.
• Deanna A. Pepe, D.O.
• Alisan Perelmut, DMD
• Yajaira Perez-Ramirez, LCSW
• Alexandra Rae Perez, NURSE PRACTITIONER

• Psychiatric/Mental Health Nurse Practitioner in Marlton, NJ
• Providers in Marlton, 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 Jul 5, 2023; 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.