Individual provider Active NPI

Beatrice O Mebude

  • Psychiatric/Mental Health Nurse Practitioner
  • Union, NJ
National Provider Identifier
1235862707
Registry record updated Jul 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01322800 Issued in NJ
Practice address
2386 Morris Ave Ste 100
Union, NJ 07083-5723
Phone
(973) 202-4986
NPI assigned
Jul 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2022

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 26NJ01322800 NJ Primary

Addresses

Primary practice location

2386 Morris Ave Ste 100
Union, NJ 07083-5723

Mailing address

2386 Morris Ave Ste 100
Union, NJ 07083-5723
Phone (973) 202-4986

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
I20230220000637 NJ Practitioner - Nurse Practitioner 3971975061 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
26NJ01322800NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amity Healthcare Services Psychiatric/Mental Health CurrentSince Jan 12, 2023 Accepting new patients
Mercy Throne Behavioral Health Institute LLC Psychiatric/Mental Health CurrentSince Jan 12, 2023 Accepting new patients
Grow Healthcare Group of New Jersey PC Psychiatric/Mental Health CurrentSince Jun 20, 2024 Accepting new patients

Locations

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

2115 Millburn Ave
Ste 100
Maplewood, NJ 07040
Phone (973) 704-9589

2386 Morris Ave
Union, NJ 07083
Phone (908) 463-7625

2386 Morris Ave
Ste 100
Union, NJ 07083
Phone (973) 202-4986

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1656720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656720000000",
    "number": "1235862707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2386 MORRIS AVE STE 100",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835723",
            "telephone_number": "973-202-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2386 MORRIS AVE STE 100",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835723",
            "telephone_number": "973-202-4986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEBUDE",
        "first_name": "BEATRICE",
        "middle_name": "O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-02",
        "last_updated": "2022-07-02",
        "certification_date": "2022-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01322800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.