Individual provider Active NPI

Wislande Fleurissant

  • Family Nurse Practitioner
  • West Orange, NJ
National Provider Identifier
1295447027
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01415300 Issued in NJ
Practice address
80 Main St
West Orange, NJ 07052-5460
Phone
(973) 489-9615
NPI assigned
Dec 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ01415300 NJ Primary

Addresses

Primary practice location

80 Main St
West Orange, NJ 07052-5460

Mailing address

80 Main St FL 3
West Orange, NJ 07052-5460

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
I20240624004914 NJ Practitioner - Nurse Practitioner 6204379803 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

201 Lyons Ave
Newark, NJ 07112-2027

5 Sayres PL
West Orange, NJ 07052-5609
Phone (973) 489-9615

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01415300NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Apr 11, 2024 Accepting new patients
Advanced Home Wound Healing & Wellness LLC Current Accepting new patients
Barnabas Health Medical Group PC CurrentSince Apr 11, 2024 Accepting new patients
Jjbrothershope Family CurrentSince Jun 22, 2024 Accepting new patients

Locations

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

235 Millburn Ave
Ste 101
Millburn, NJ 07041
Phone (973) 376-8034

80 Main St
West Orange, NJ 07052
Phone (973) 243-9666

80 Main St
Fl 3
West Orange, NJ 07052

Interoperability endpoints

  • Direct secure messaging: wfleurissant239279@epicdirect.rwjbh.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1671753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1295447027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MAIN ST FL 3",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070525460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MAIN ST",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070525460",
            "telephone_number": "973-489-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEURISSANT",
        "first_name": "WISLANDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-23",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01415300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.