Individual provider Active NPI

Naom Nyamoita Mongare

  • Family Nurse Practitioner
  • Jersey City, NJ
National Provider Identifier
1184399644
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01160000 Issued in NJ
Practice address
377 Jersey Ave
Jersey City, NJ 07302-4393
Phone
(201) 744-9306
NPI assigned
Aug 16, 2021
Last updated
Aug 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ01160000 NJ Primary

Addresses

Primary practice location

377 Jersey Ave
Jersey City, NJ 07302-4393

Mailing address

15 Suburbia Dr # 2
Jersey City, NJ 07305-1253
Phone (201) 889-2109

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
I20220822000058 NJ Practitioner - Nurse Practitioner 0042693202 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Value Based Long Term Care H PCGroup PAC ID 4587104641, 145 clinicians
Community Primary Care PCGroup PAC ID 5991098493, 5 clinicians

Practice addresses (Care Compare)

103 Carnegie Ctr
Suite 300
Princeton, NJ 08540-6235
Phone (888) 964-6681

377 Jersey Ave
Suite 590
Jersey City, NJ 07302-4691
Phone (201) 744-9306

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
HDC Care Solutions, LLC Family CurrentSince Jan 1, 2024 Accepting new patients
Value Based Long Term Care H PC CurrentSince May 10, 2025 Accepting new patients
Healthdrive Medical Services Southeast LLC Family CurrentSince Aug 1, 2025 Accepting new patients
Community Primary Care, PC CurrentSince Sep 9, 2025 Accepting new patients

Locations

377 Jersey Ave
Ste 590
Jersey City, NJ 07302
Phone (201) 744-9306

103 Carnegie Ctr
Ste 300
Princeton, NJ 08540
Phone (609) 524-2514

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GFFCDD

Organizations & group practices 6

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": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1184399644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SUBURBIA DR # 2",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073051253",
            "telephone_number": "201-889-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 JERSEY AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024393",
            "telephone_number": "201-744-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONGARE",
        "first_name": "NAOM",
        "middle_name": "NYAMOITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01160000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.