Ijeoma Miracle Nwobu

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

06356750 Issued in NJ

Practice address

301 Sicomac Ave
Wyckoff, NJ 07481-2159

Phone

(917) 224-8622

NPI assigned

Oct 5, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Stress Care of New Jersey, LLCGroup PAC ID 5294864575, 48 clinicians

You Bridge HealthGroup PAC ID 0446618219, 2 clinicians

Gold Standard Medical Group PCGroup PAC ID 2961762554, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Stress Care of New Jersey, LLC

  • Community/Behavioral Health Agency
  • Matawan, NJ
  • NPI 1033433834
  Medicare reassignment Care Compare group NPD
• You Bridge Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Iselin, NJ
  • NPI 1275222499
  Medicare reassignment Care Compare group NPD
• Gold Standard Medical Group PC

  • Internal Medicine Physician
  • Clifton, NJ
  • NPI 1043722853
  Medicare reassignment Care Compare group
• Velora Behavioral Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Irvington, NJ
  • NPI 1447183215
  NPD Authorized official
• Stress Care of New Jersey, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Somerset, NJ
  • NPI 1982345567
  NPD

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

{
    "created_epoch": "1728086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728086400000",
    "number": "1396564548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 PHILIP PL",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071112908",
            "telephone_number": "917-224-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SICOMAC AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074812159",
            "telephone_number": "917-224-8622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWOBU",
        "first_name": "IJEOMA",
        "middle_name": "MIRACLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-05",
        "last_updated": "2024-10-05",
        "certification_date": "2024-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "06356750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Norton, PTA
• Marisa Rodrigo Nunez, PSYD
• Nurturing Neurodivergence, LLC
• Nutrition for Life Limited Liability Company
• Nutrition Matters, LLC
• Ny NJ Anesthesia LLC
• Charizza Olegario, PT
• Joseph Anthony Oliveri Sr., R. P.
• Optimal Nutrition Solutions of NJ, LLC
• Osteopathic Family Medicine of Northern NJ LLC

• Psychiatric/Mental Health Nurse Practitioner in Wyckoff, NJ
• Providers in Wyckoff, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.