Anatoly Maloletkin

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ15306000 Issued in NJ

Practice address

2185 Lemoine Ave Ste 1H
Fort Lee, NJ 07024-6030

Phone

(888) 701-6472

NPI assigned

Apr 21, 2025

Sex

Male

Sole proprietor

No

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

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Tri America Tmsketa LLCGroup PAC ID 8628462397, 4 clinicians

Bridgecare Provider Group LLCGroup PAC ID 8123498193, 7 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.

• Bridgecare Provider Group LLC

  • Primary Care Nurse Practitioner
  • Wayne, NJ
  • NPI 1164148672
  Medicare reassignment Care Compare group NPD
• Tri America Tmsketa

  • Psychiatry Physician
  • Fort Lee, NJ
  • NPI 1417612250
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1745193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1215724539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 LEMOINE AVE STE 1H",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246030",
            "telephone_number": "888-701-6472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2185 LEMOINE AVE STE 1H",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246030",
            "telephone_number": "888-701-6472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALOLETKIN",
        "first_name": "ANATOLY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-21",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15306000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Risheng Ma, LAC
• Magnolia Adult Day Care LLC
• Magnolia Adult Day Habilitation LLC
• Lauren Virginia Malajian, PT, DPT
• Vera Malezhik, DPM
• Mukundha Belliappa Maneyapanda, M.D.
• Michael John Marcano
• Robert J Marchetti
• Stanley Markman, DDS
• Angela Marie Marquez, OT-LP

• Psychiatric/Mental Health Nurse Practitioner in Fort Lee, NJ
• Providers in Fort Lee, 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 Apr 21, 2025; 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.