Ann Frances De Jong, RN, PHD
Individual provider Active NPI Psychiatric/Mental Health Clinical Nurse Specialist · Sea Girt, NJ
NPI 1386844512 · NPPES record last updated Apr 14, 2021
Key facts
- NPI
- 1386844512
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X
- License
- 305769 (NJ)
- Practice address
- 215 Stockton Blvd
Sea Girt, NJ 08750 - Phone
- (973) 476-6517
- Fax
- (862) 333-4950
- NPI assigned
- Jul 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1973
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Nellysford, VA 22958
Phone (973) 476-6517
215 Stockton Blvd
Sea Girt, NJ 08750-3228
Phone (973) 476-6517
701 Stoney CRK W
Nellysford, VA 22958-8067
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NJ, VA
- 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 |
|---|---|---|---|---|
| I20060417000644 | NJ | Practitioner - Nurse Practitioner | 6305855503 | Practice locations: Sea Girt, NJ |
| I20250213002540 | VA | Practitioner - Nurse Practitioner | 6305855503 | Practice locations: Nellysford, VA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner, Doctor of Philosophy, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 305769 | NJ | MD | Psychiatric/Mental Health Clinical Nurse Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0808X | 305769 | NJ | Yes |
Addresses
Primary practice location
215 Stockton Blvd
Sea Girt, NJ 08750
Mailing address
311 Claremont Avenue
Montclair, NJ 07042
Phone (973) 744-2888
Other providers in Sea Girt, NJ
- Sue Dalrymple
- Casey E Dambeck
- Michael David Dambeck
- Sunshyne Darcy
- David a. Pupa, LCSW, LLC
- Anthony C De Luca
- Robert Demartin
- Depko Cognitive Therapy
- Depko Counseling and Consulting LLC
- Laura E Depko
All providers in Sea Girt, NJ · 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 Apr 14, 2021. 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.