Individual provider Active NPI

Kelsie Alexa Lotito, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • West Orange, NJ
National Provider Identifier
1225872062
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ15159400 Issued in NJ
Practice address
470 Prospect Ave Ste 202
West Orange, NJ 07052-4106
Phone
(973) 325-5100
NPI assigned
Jun 25, 2024
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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 26NJ15159400 NJ Primary

Addresses

Primary practice location

470 Prospect Ave Ste 202
West Orange, NJ 07052-4106

Mailing address

109 Cherry Tree Farm Rd
Middletown, NJ 07748-1740
Phone (646) 707-7515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241114004335 NJ Practitioner - Nurse Practitioner 9335673144 Reassigns benefits to 1 organization
I20241122002883 NY Practitioner - Nurse Practitioner 9335673144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Elangovan Psychiatric Services PLLCGroup PAC ID 2860867447, 6 clinicians
Elangovan Psychiatric Services LLCGroup PAC ID 8729460894, 3 clinicians

Practice addresses (Care Compare)

1756 Richmond Ave
Staten Island, NY 10314-3902
Phone (718) 477-5670

470 Prospect Ave
West Orange, NJ 07052-4106
Phone (973) 325-5100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ15159400NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elangovan Psychiatric Services LLC CurrentSince Oct 17, 2024 Accepting new patients
Christ Medical Transport LLC CurrentSince Jun 30, 2024 Accepting new patients
Elangovan Psychiatric Services PLLC CurrentSince Oct 31, 2024 Accepting new patients

Locations

470 Prospect Ave
Ste 202
West Orange, NJ 07052
Phone (973) 325-5100

470 Prospect Ave
Ste 102
West Orange, NJ 07052
Phone (973) 325-4100

1756 Richmond Ave
Staten Island, NY 10314
Phone (718) 477-5670

Organizations & group practices 3

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": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1225872062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CHERRY TREE FARM RD",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077481740",
            "telephone_number": "646-707-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 PROSPECT AVE STE 202",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524106",
            "telephone_number": "973-325-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOTITO",
        "first_name": "KELSIE",
        "middle_name": "ALEXA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15159400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.