Individual provider Active NPI

Kenneth E Ogali, DNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1215523493
Registry record updated Dec 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01051500 Issued in NJ
Practice address
207 Smith St
Newark, NJ 07106-1709
Phone
(908) 967-7770
NPI assigned
Dec 12, 2020
Last updated
Dec 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ01051500 NJ Primary

Addresses

Primary practice location

207 Smith St
Newark, NJ 07106-1709

Mailing address

207 Smith St
Newark, NJ 07106-1709
Phone (908) 967-7770

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
I20230404002919 NJ Practitioner - Nurse Practitioner 2961877956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

30 Knightsbridge Rd
Suite 625
Piscataway, NJ 08854-3948

30 Knightsbridge Rd
Suite 625
Piscataway, NJ 08854-3962

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01051500NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health - Behavioral Health Multi-Specialty CurrentSince Mar 22, 2023 Accepting new patients
Rutgers Health - Behavioral Health Multi-Specialty Current Accepting new patients

Locations

100 Metroplex Dr
Fl 2
Edison, NJ 08817

183 S Orange Ave
Newark, NJ 07103
Phone (973) 972-0480

671 Hoes Ln W
Rm D3381
Piscataway, NJ 08854
Phone (732) 235-3289

Organizations & group practices 2

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": "1607731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607731200000",
    "number": "1215523493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 SMITH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071061709",
            "telephone_number": "908-967-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 SMITH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071061709",
            "telephone_number": "908-967-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGALI",
        "first_name": "KENNETH",
        "middle_name": "E",
        "credential": "DNP, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-12",
        "last_updated": "2020-12-12",
        "certification_date": "2020-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01051500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.