Amy Marie Derrick, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ14857300 Issued in NJ

Practice address

2640 Highway 70 Ste 201
Manasquan, NJ 08736-2609

Phone

(327) 202-0622

Fax

(732) 202-0620

NPI assigned

Dec 2, 2021

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

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Preferred Behavioral Health of New Jersey IncGroup PAC ID 3971414533, 36 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 and National Provider Directory roles.

• Preferred Behavioral Health of New Jersey, Inc.

  • Community/Behavioral Health Agency
  • Lakewood, NJ
  • NPI 1386701894
  Medicare reassignment Care Compare group NPD
• Brick Psychiatric Services Inc

  • Psychiatry Physician
  • Manasquan, NJ
  • NPI 1992818777
  Medicare reassignment NPD
• Preferred Behavioral Health of New Jersey, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Barnegat, NJ
  • NPI 1720773526
  NPD
• Preferred Behavioral Health of New Jersey, Inc.

  • Community/Behavioral Health Agency
  • Lakewood, NJ
  • NPI 1801943717
  NPD

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1174281513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 LUKAS BLVD",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077519741",
            "telephone_number": "732-598-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 HIGHWAY 70 STE 201",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087362609",
            "telephone_number": "327-202-0622",
            "fax_number": "732-202-0620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 Roszel Rd Ste A103",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "NJ",
            "postal_code": "085406234",
            "country_code": "US",
            "telephone_number": "609-419-0123",
            "fax_number": "609-419-0126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERRICK",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-02",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR18163900",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ14857300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deonde R Degennaro, PA-C
• Maureen Whelan Dejacimo, OTR
• Gustavo Delaluz, MD
• Katherine Delorenzo, DPT
• Frederick A Depaola, M.D.
• Dawn Marie Devenny
• Dietrich Opticians, PA
• Alexa Dipierro
• Diane Michele Ditusa, D.O., M.P.H.
• Nancy Elizabeth Donahue, LCSW

• Psychiatric/Mental Health Nurse Practitioner in Manasquan, NJ
• Providers in Manasquan, 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 Oct 24, 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.