Individual provider Active NPI

Alexter Mutia, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Boonton, NJ
National Provider Identifier
1407108582
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00384800 Issued in NJ
Practice address
130 Powerville Rd
Boonton, NJ 07005-8705
Phone
(201) 371-3076
NPI assigned
Oct 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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 26NJ00384800 NJ Primary

Addresses

Primary practice location

130 Powerville Rd
Boonton, NJ 07005-8705

Mailing address

130 Powerville Rd
Boonton, NJ 07005-8705
Phone (201) 371-3076

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
I20131030001028 NJ Practitioner - Nurse Practitioner 5294960142 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Internal Medicine of Morris County LLCGroup PAC ID 2466428388, 77 clinicians
Center for Family Guidance PCGroup PAC ID 2860396454, 164 clinicians

Practice addresses (Care Compare)

350 Boulevard
Passaic, NJ 07055-2840
Phone (973) 366-6060

765 Route 70 E
BLDG a
Marlton, NJ 08053-2341
Phone (856) 983-3900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00384800NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Family Guidance, PC Psychiatric/Mental Health CurrentSince Sep 1, 2013 Accepting new patients
Acenda, Inc. CurrentSince Dec 20, 2022 Accepting new patients

Locations

130 Powerville Rd
Boonton Twp, NJ 07005
Phone (973) 316-1800

333 Irving Ave
Bridgeton, NJ 08302
Phone (856) 575-4500

25 Pocono Rd
Denville, NJ 07834
Phone (273) 625-6000

42 Delsea Dr S
Glassboro, NJ 08028
Phone (856) 863-0006

765 Route 70 E
Bldg A
Marlton, NJ 08053
Phone (856) 797-4721

254 Easton Ave
New Brunswick, NJ 08901
Phone (732) 565-5453

350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: alexter.mutia.p1@direct.cfg.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1407108582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 POWERVILLE RD",
            "city": "BOONTON",
            "state": "NJ",
            "postal_code": "070058705",
            "telephone_number": "201-371-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 POWERVILLE RD",
            "city": "BOONTON",
            "state": "NJ",
            "postal_code": "070058705",
            "telephone_number": "201-371-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTIA",
        "first_name": "ALEXTER",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-12",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00384800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boonton, NJ

Sources for this page

Verify at the official NPI Registry.