Individual provider Active NPI

Jude Chineto Emelumba, APN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Trenton, NJ
National Provider Identifier
1396185567
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00443500 Issued in NJ
Practice address
314 E State St
Trenton, NJ 08608
Phone
(609) 396-5944
Fax
(609) 394-0405
NPI assigned
Jul 2, 2013
Last updated
Oct 5, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00443500 NJ Primary

Addresses

Primary practice location

314 E State St
Trenton, NJ 08608

Mailing address

272 Forrest St
Jersey City, NJ 07304-2239
Phone (551) 247-8105

Other identifiers 1

IdentifierTypeStateIssuer
0382914MedicaidNJ

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
I20130925000802 NJ Practitioner - Nurse Practitioner 9032353438 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Garden State Healthcare Associates LLCGroup PAC ID 8426190687, 171 clinicians

Practice addresses (Care Compare)

176 Palisade Ave
Jersey City, NJ 07306-1121
Phone (201) 795-8200

37 -39 Bloomfield Ave
Newark, NJ 07104-2536
Phone (973) 573-1648

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Great Shepherd Behavorial Health Center Psychiatric/Mental Health CurrentSince Jun 4, 2021 Accepting new patients
Trinitas Regional Medical Center CurrentSince Apr 12, 2018 Accepting new patients
Trinitas Regional Medical Center CurrentSince Apr 12, 2018 Accepting new patients
Garden State Healthcare Associates, LLC CurrentSince Aug 5, 2019 Accepting new patients
Greater Trenton CMHC Inc. Past Accepting new patients

Locations

601 Broadway
Bayonne, NJ 07002
Phone (201) 339-9200

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

176 Palisade Ave
Jersey City, NJ 07306
Phone (201) 795-8200

37-39 Bloomfield Ave
Newark, NJ 07104
Phone (973) 573-1648

Organizations & group practices 5

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 2

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": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1396185567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "272 FORREST ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073042239",
            "telephone_number": "551-247-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 E STATE ST",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "08608",
            "telephone_number": "609-396-5944",
            "fax_number": "609-394-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMELUMBA",
        "first_name": "JUDE",
        "middle_name": "CHINETO",
        "name_prefix": "Mr.",
        "credential": "APN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-02",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00443500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0382914",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

Verify at the official NPI Registry.