Kelly Cantisano
Individual provider Active NPI Adult Psychiatric/Mental Health Clinical Nurse Specialist · Ewing, NJ
NPI 1265833859 · NPPES record last updated Sep 15, 2014
Key facts
- NPI
- 1265833859
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X
- License
- 26NJ00005800 (NJ)
- Practice address
- 830 Bear Tavern Rd
Medop Behavioral Health Associates of NJ PC
Ewing, NJ 08628-1020 - Phone
- (973) 800-2655
- NPI assigned
- Sep 15, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Barnabas Health Medical Group, PC
Practice addresses (Care Compare)
1 Clara Maass Dr
Belleville, NJ 07109-3550
Phone (973) 450-2000
201 Lyons Ave
Newark, NJ 07112-2027
Phone (732) 923-7455
Merit-based Incentive Payment System (MIPS)
- Final score
- 98.51 of 100
- Quality
- 84.27
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141106001427 | NJ | Practitioner - Nurse Practitioner | 6002038015 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ00005800 | NJ | MD | Adult Psychiatric/Mental Health Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barnabas Health Medical Group, PC | Current |
Accepting new patients |
Locations
1 Clara Maass Dr
Belleville, NJ 07109
Phone (973) 450-2008
201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455
266 King George Rd
Warren, NJ 07059
Phone (732) 667-7778
223 Monmouth Rd
West Long Branch, NJ 07764
Phone (732) 229-3838
Interoperability endpoints
- kcantisano48184@epicdirect.rwjbh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0809X | 26NJ00005800 | NJ | Yes |
Addresses
Primary practice location
830 Bear Tavern Rd
Medop Behavioral Health Associates of NJ PC
Ewing, NJ 08628-1020
Mailing address
830 Bear Tavern Rd
Medop Behavioral Health Associates of NJ PC
Ewing, NJ 08628-1020
Other providers in Ewing, NJ
- John J Cambria
- Joseph John Camillone
- Doneisha Campbell
- Edward Sidney Campell
- Katherina Canales
- Stephanie Payne Capecchi
- Capital Health Center for Digestive Health
- Capital Health Plastic Surgery
- Lauren Caporoso
- Rachel Capuano
All providers in Ewing, NJ · Adult Psychiatric/Mental Health Clinical Nurse Specialist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.