Individual provider Active NPI

Nicole Clyde, NP

  • Nurse Practitioner
  • Asbury Park, NJ
National Provider Identifier
1407708878
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ15524300 Issued in NJ
Practice address
300 7TH Ave
Asbury Park, NJ 07712-5283
Phone
(609) 433-5250
NPI assigned
Feb 10, 2026
Last updated
Feb 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ15524300 NJ Primary

Addresses

Primary practice location

300 7TH Ave
Asbury Park, NJ 07712-5283

Mailing address

300 7TH Ave
Asbury Park, NJ 07712-5283
Phone (609) 433-5250

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
I20260330002264 NJ Practitioner - Nurse Practitioner 2466937230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

404 Creek Crossing Blvd
Hainesport, NJ 08036-2768

6 W End CT
Unit 301
Long Branch, NJ 07740-9132

PO Box
Suite 90
Allamuchy, NJ 07820

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ15524300NJMDNurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1770681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1407708878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 7TH AVE",
            "city": "ASBURY PARK",
            "state": "NJ",
            "postal_code": "077125283",
            "telephone_number": "609-433-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 7TH AVE",
            "city": "ASBURY PARK",
            "state": "NJ",
            "postal_code": "077125283",
            "telephone_number": "609-433-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYDE",
        "first_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-10",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ15524300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asbury Park, NJ

Sources for this page

Verify at the official NPI Registry.