Kelly Nussbaum, APRN

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

26NC07471600 Issued in NJ

Practice address

163 Engle St Ste 4a
Englewood, NJ 07631-2530

Phone

(201) 408-4487

Fax

(800) 352-3015

NPI assigned

May 5, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kelly Nussbaum Former name

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, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Internal Medicine of Morris County LLCGroup PAC ID 2466428388, 77 clinicians

KND Development 59 LLCGroup PAC ID 3678602802, 176 clinicians

Center for Family Guidance PCGroup PAC ID 2860396454, 164 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Michael'S Medical Center Hospital, Newark, NJ, CCN 310096

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: kelly.nussbaum.p1@direct.cfg.nextgenshare.com

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.

• Center for Family Guidance, PC

  • Geriatric Psychiatry Physician
  • Marlton, NJ
  • NPI 1508803388

  NJ, Psychiatric/Mental Health, Adult

  Medicare reassignment Care Compare group NPD
• KND Development 59, LLC

  • Hospitalist Physician
  • Passaic, NJ
  • NPI 1538498290

  NJ

  Medicare reassignment Care Compare group NPD
• Internal Medicine of Morris County LLC

  • Internal Medicine Physician
  • Mine Hill, NJ
  • NPI 1568570489

  NJ

  Medicare reassignment Care Compare group
• Garden State Healthcare Associates, LLC

  • Emergency Medicine Physician
  • Bayonne, NJ
  • NPI 1700014545

  NJ

  Medicare reassignment NPD
• NJ Memory and Behavioral Care

  • Geriatric Psychiatry Physician
  • Cedar Knolls, NJ
  • NPI 1538499181

  NJ

  Medicare reassignment NPD
• Prime Healthcare Services - Saint Clare'S LLC

  • General Acute Care Hospital
  • Denville, NJ
  • NPI 1497134274

  NJ

  Medicare reassignment NPD
• KND Development 59, LLC

  • Hospitalist Physician
  • Dover, NJ
  • NPI 1114256989
  Care Compare group
• KND Development 59 , LLC

  • Hospitalist Physician
  • West Monroe, LA
  • NPI 1558058917
  Care Compare group
• KND Development 59 , LLC

  • Hospitalist Physician
  • Greensboro, NC
  • NPI 1619206133
  Care Compare group
• KND Development 59 LLC

  • Hospitalist Physician
  • Louisville, KY
  • NPI 1164751756
  Care Compare group
• KND Development 59 LLC

  • Hospitalist Physician
  • Albuquerque, NM
  • NPI 1215266754
  Care Compare group
• KND Development 59 LLC

  • Hospitalist Physician
  • Saint Petersburg, FL
  • NPI 1245569870
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prime Healthcare Services - St Michaels LLC

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1568825545

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304553600000",
    "number": "1215229596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 RICKER RD",
            "city": "KINNELON",
            "state": "NJ",
            "postal_code": "07405",
            "telephone_number": "973-838-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 ENGLE ST STE 4A",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312530",
            "telephone_number": "201-408-4487",
            "fax_number": "800-352-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSSBAUM",
        "first_name": "KELLY",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-05",
        "last_updated": "2011-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "NJ",
            "license": "26NC07471600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "NUSSBAUM",
            "prefix": "MS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Englewood, NJ
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2011; 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.