Individual provider Active NPI

Marie Juline Cherubin, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Maplewood, NJ
National Provider Identifier
1245975861
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01301900 Issued in NJ
Practice address
1560 Springfield Ave
Maplewood, NJ 07040-2414
Phone
(848) 256-9392
Fax
(908) 402-4846
NPI assigned
Apr 28, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 26NJ01301900 NJ Primary

Addresses

Primary practice location

1560 Springfield Ave
Maplewood, NJ 07040-2414

Mailing address

1560 Springfield Ave
Maplewood, NJ 07040-2414
Phone (848) 256-9392

Other practice location 1

99 Beauvoir Ave
Summit, NJ 07901-3533
Phone (908) 522-2000

Other practice location 2

550 Broad St Ste 606
Newark, NJ 07102-4537
Phone (201) 822-1161

Other identifiers 1

IdentifierTypeStateIssuer
0847208MedicaidNJ

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
I20220712001946 NJ Practitioner - Nurse Practitioner 1153701818 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

1560 Springfield Ave
Maplewood, NJ 07040-2414
Phone (848) 256-9392

99 Beauvoir Ave
Summit, NJ 07902-3533
Phone (908) 522-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01301900NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trinitas Regional Medical Center CurrentSince Jul 14, 2023 Accepting new patients
Theos Health Care LLC Single Specialty CurrentSince Jun 6, 2023 Accepting new patients
Garden State Healthcare Associates, LLC Single Specialty CurrentSince Aug 1, 2022 Accepting new patients
JLS Medical PC Single Specialty CurrentSince Jun 9, 2023 Accepting new patients
Trinitas Regional Medical Center CurrentSince Jul 14, 2023 Accepting new patients
Trinitas Regional Medical Center Single Specialty Current Accepting new patients
Practice Associates Medical Group Single Specialty CurrentSince Aug 1, 2022 Accepting new patients
Bancroft, a New Jersey Nonprofit Corporation Single Specialty PastSince Jun 1, 2023 Accepting new patients

Locations

601 Broadway
Bayonne, NJ 07002
Phone (201) 339-9200

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

176 Palisade Ave
Jersey City, NJ 07306
Phone (201) 795-8200

1560 Springfield Ave
Maplewood, NJ 07040
Phone (848) 256-9392

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

550 Broad St
Ste 606
Newark, NJ 07102
Phone (425) 458-8525

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

Interoperability endpoints

  • Direct secure messaging: marie.cherubin.d1.p1@direct.nhscnj.nextgenshare.com

Organizations & group practices 8

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": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1245975861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 SPRINGFIELD AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070402414",
            "telephone_number": "848-256-9392",
            "fax_number": "908-402-4846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 SPRINGFIELD AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070402414",
            "telephone_number": "848-256-9392",
            "fax_number": "908-402-4846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99 Beauvoir Ave",
            "address_purpose": "LOCATION",
            "city": "Summit",
            "state": "NJ",
            "postal_code": "079013533",
            "country_code": "US",
            "telephone_number": "908-522-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 Broad St Ste 606",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071024537",
            "country_code": "US",
            "telephone_number": "201-822-1161",
            "fax_number": "877-485-8918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHERUBIN",
        "first_name": "MARIE",
        "middle_name": "JULINE",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-28",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01301900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0847208",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, NJ

Sources for this page

Verify at the official NPI Registry.