Individual provider Active NPI

Andrea Brassard, NP

  • Family Nurse Practitioner
  • Newfoundland, NJ
National Provider Identifier
1417995341
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00054600 Issued in NJ
Practice address
3 Shadyside LN
Newfoundland, NJ 07435-1126
Phone
(301) 892-2426
NPI assigned
Jun 3, 2006
Last updated
Feb 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00054600 NJ Primary

Addresses

Primary practice location

3 Shadyside LN
Newfoundland, NJ 07435-1126

Mailing address

3 Shadyside LN
Newfoundland, NJ 07435-1126
Phone (301) 892-2426

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
I20250728001946 NJ Practitioner - Nurse Practitioner 6002918786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4390 Route 130
Suite a
Willingboro, NJ 08046-1065
Phone (267) 781-7315

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Life Choice Hospice of New Jersey, LLC CurrentSince May 10, 2025 Accepting new patients
Northwest Nurse Practitioner Associates Inc Past Accepting new patients
Life Choice Hospice of New Jersey, LLC Past Accepting new patients

Locations

4390 Route 130
Ste A
Willingboro, NJ 08046
Phone (267) 781-7315

10 Cadillac Dr
Ste 400
Brentwood, TN 37027
Phone (615) 637-9163

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, 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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1417995341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SHADYSIDE LN",
            "city": "NEWFOUNDLAND",
            "state": "NJ",
            "postal_code": "074351126",
            "telephone_number": "301-892-2426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SHADYSIDE LN",
            "city": "NEWFOUNDLAND",
            "state": "NJ",
            "postal_code": "074351126",
            "telephone_number": "301-892-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASSARD",
        "first_name": "ANDREA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-03",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00054600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newfoundland, NJ

Sources for this page

Verify at the official NPI Registry.