Individual provider Active NPI

Maureen Ndu, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Elizabeth, NJ
National Provider Identifier
1447725395
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00850500 Issued in NJ
Practice address
333 N Broad St Ste 205
Elizabeth, NJ 07208
Phone
(908) 576-7617
Fax
(908) 576-7616
NPI assigned
Oct 8, 2018
Last updated
Jan 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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 26NJ00850500 NJ Primary

Addresses

Primary practice location

333 N Broad St Ste 205
Elizabeth, NJ 07208

Mailing address

18 Arsdale Ter
Union, NJ 07083-4401
Phone (908) 418-8599

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Desktop

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
I20191014000468 NJ Practitioner - Nurse Practitioner 5890026496 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Medical Consult Single Specialty CurrentSince Aug 21, 2019 Accepting new patients
Rutgers Health - Behavioral Health Single Specialty CurrentSince Dec 7, 2021 Accepting new patients
Rutgers Health - Behavioral Health Single Specialty Current Accepting new patients
L&a Absolute Care LLC Single Specialty Past Accepting new patients

Locations

40 Union Ave
Ste 301
Irvington, NJ 07111
Phone (862) 849-2618

183 S Orange Ave
Newark, NJ 07103
Phone (973) 972-0480

671 Hoes Ln W
Rm D3381
Piscataway, NJ 08854
Phone (732) 235-3289

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.

NPI Registry JSON

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1447725395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 ARSDALE TER",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070834401",
            "telephone_number": "908-418-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N BROAD ST STE 205",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "07208",
            "telephone_number": "908-576-7617",
            "fax_number": "908-576-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDU",
        "first_name": "MAUREEN",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00850500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Desktop",
            "affiliation": "N",
            "address_1": "333 N Broad St Ste 205",
            "city": "Elizabeth",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "07208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.