Individual provider Active NPI

Elizabeth Kroliczak Lewis, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1376944561
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00782600 Issued in NJ
Practice address
550 Mayor Gibson Blvd Ste 606
Newark, NJ 07102-4537
Phone
(201) 822-1161
NPI assigned
Sep 8, 2014
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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 SP035492 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00782600 NJ Primary
Adult Health Nurse Practitioner 363LA2200X SP014392 PA

Addresses

Primary practice location

550 Mayor Gibson Blvd Ste 606
Newark, NJ 07102-4537

Mailing address

134 Bridgeton Pike Ste D
Mullica Hill, NJ 08062-2616
Phone (856) 507-2783

Other practice location 1

795 E Lancaster Ave Ste 210
Villanova, PA 19085-1525
Phone (215) 254-6000

Other practice location 2

536 Lippincott Dr
Marlton, NJ 08053-4805
Phone (856) 355-7155

Other practice location 3

8025 Black Horse Pike Ste 501
Pleasantville, NJ 08232-2967
Phone (609) 464-1433

Other practice location 4

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone (484) 337-3369

Other names 1

  • Elizabeth Kroliczak Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150108000848 PA Practitioner - Nurse Practitioner 2062735509 Reassigns benefits to 3 organizations
I20180205000815 NJ Practitioner - Nurse Practitioner 2062735509 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians
Inspira Health Network Medical Group PCGroup PAC ID 4880797570, 238 clinicians
Virtua Medical Group, PAGroup PAC ID 9830222397, shared by 13 NPIs, 1,678 clinicians

Practice addresses (Care Compare)

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121

130 S Bryn Mawr Ave H
321 GVH Hospital Medical Services Bryn
Bryn Mawr, PA 19010-3121
Phone (484) 337-4097

1505 W Sherman Ave
Vineland, NJ 08360-7059
Phone (856) 641-7960

1600 Haddon Ave
Camden, NJ 08103-3101

3242 Route 206
Bordentown, NJ 08505-4517

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP035492PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Angelic Health Practice Group Current Accepting new patients
JLS Medical PC Psychiatric/Mental Health CurrentSince Mar 18, 2026 Accepting new patients
Angelic Health Practice Group CurrentSince Mar 12, 2024 Accepting new patients
HCR Manorcare Medical Services of Florida LLC CurrentSince Jan 26, 2018 Accepting new patients
Angelic Health Practice Group CurrentSince May 7, 2024 Accepting new patients
Angelic Health Practice Group CurrentSince Mar 12, 2024 Accepting new patients
Main Line Healthcare CurrentSince Nov 17, 2014 Accepting new patients
Inspira Health Network Medical Group, P.C. CurrentSince Jan 12, 2026 Accepting new patients
Atlantic Hospice, Inc. PastSince Sep 12, 2018 Accepting new patients
Virtua Medical Group, PA Past Accepting new patients
Bancroft, a New Jersey Nonprofit Corporation PastSince Mar 18, 2026 Accepting new patients

Locations

1412 Marlton Pike E
Cherry Hill, NJ 08034
Phone (856) 428-1600

134 Bridgeton Pike
Ste D
Mullica Hill, NJ 08062
Phone (856) 233-9888

550 Mayor Gibson Blvd
Ste 606
Newark, NJ 07102
Phone (609) 325-8741

798 Centerton Rd
Pittsgrove, NJ 08318
Phone (856) 358-6161

8025 Black Horse Pike
Ste 501
Pleasantville, NJ 08232
Phone (609) 464-1135

1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600

L2540
Columbus, OH 43260

486 Norristown Rd
Ste 133B
Blue Bell, PA 19422
Phone (267) 995-4086

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010
Phone (484) 337-3000

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

3855 West Chester Pike
Ste 300
Newtown Square, PA 19073
Phone (484) 337-2585

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

Organizations & group practices 12

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.

Hospital & facility affiliations 4

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": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1376944561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 BRIDGETON PIKE STE D",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080622616",
            "telephone_number": "856-507-2783",
            "fax_number": "856-221-4138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MAYOR GIBSON BLVD STE 606",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071024537",
            "telephone_number": "201-822-1161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "795 E Lancaster Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Villanova",
            "state": "PA",
            "postal_code": "190851525",
            "country_code": "US",
            "telephone_number": "215-254-6000",
            "fax_number": "215-754-1705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "536 Lippincott Dr",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080534805",
            "country_code": "US",
            "telephone_number": "856-355-7155",
            "fax_number": "856-325-4798",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8025 Black Horse Pike Ste 501",
            "address_purpose": "LOCATION",
            "city": "Pleasantville",
            "state": "NJ",
            "postal_code": "082322967",
            "country_code": "US",
            "telephone_number": "609-464-1433",
            "fax_number": "610-647-2006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 S Bryn Mawr Ave",
            "address_purpose": "LOCATION",
            "city": "Bryn Mawr",
            "state": "PA",
            "postal_code": "190103121",
            "country_code": "US",
            "telephone_number": "484-337-3369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ELIZABETH",
        "middle_name": "KROLICZAK",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP035492",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00782600",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP014392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "KROLICZAK",
            "credential": "APN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.