Individual provider Active NPI

Jacqueline Torgbor, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Old Bridge, NJ
National Provider Identifier
1366952137
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01269800 Issued in NJ
Practice address
7A Brynwood GDNS Apt 5
Old Bridge, NJ 08857-2387
Phone
(646) 683-0572
NPI assigned
Oct 6, 2017
Last updated
Sep 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 282894 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ01269800 NJ Primary
Registered Nurse 163W00000X 26NR16311400 NJ

Addresses

Primary practice location

7A Brynwood GDNS Apt 5
Old Bridge, NJ 08857-2387

Mailing address

7A Brynwood GDNS Apt 5
Old Bridge, NJ 08857-2387
Phone (646) 683-0572

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
I20231013001086 NJ Practitioner - Nurse Practitioner 3173978921 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR16311400NJMDRegistered Nurse
282894GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shekinah Health Services LLC Psychiatric/Mental Health CurrentSince Oct 1, 2023 Accepting new patients
Aldad Medical NJ, P.C CurrentSince Oct 1, 2023 Accepting new patients
Mindwell Behavioral Health Past Accepting new patients

Locations

221 River St
Ste 901
Hoboken, NJ 07030
Phone (201) 308-8252

656 Hamilton St
Somerset, NJ 08873
Phone (646) 683-0572

510 Hempstead Tpke
Rm 203
West Hempstead, NY 11552
Phone 51650572001051

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": "1507248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1366952137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7A BRYNWOOD GDNS APT 5",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572387",
            "telephone_number": "646-683-0572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7A BRYNWOOD GDNS APT 5",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572387",
            "telephone_number": "646-683-0572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORGBOR",
        "first_name": "JACQUELINE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-06",
        "last_updated": "2023-09-05",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "282894",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01269800",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR16311400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

Verify at the official NPI Registry.