Carissa Nichole Depew, DNP, AGPCNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ15094400 Issued in NJ

Practice address

530 New Brunswick Ave
Perth Amboy, NJ 08861-3654

Phone

(732) 442-3700

NPI assigned

Aug 17, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Carissa Nicole Myers Former name

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• JFK University Medical Center Hospital, Edison, NJ, CCN 310108

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249
  Medicare reassignment Care Compare group NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD
• Wellmont Medical Associates Inc

  • Family Medicine Physician
  • Big Stone Gap, VA
  • NPI 1174808216
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HMH Hospitals Corporation

  • General Acute Care Hospital
  • Edison, NJ
  • NPI 1144894577
  Care Compare affiliation
• HMH Hospitals Corporation

  • Clinical Medical Laboratory
  • Edison, NJ
  • NPI 1780301366

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1477079861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NEW BRUNSWICK AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613654",
            "telephone_number": "732-442-3700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046035",
            "country_code": "US",
            "telephone_number": "423-431-6111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1420 Tusculum Blvd",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377454279",
            "country_code": "US",
            "telephone_number": "423-787-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 Brookside Dr",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376604627",
            "country_code": "US",
            "telephone_number": "423-857-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2202 N John B Dennis Hwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376605904",
            "country_code": "US",
            "telephone_number": "423-578-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Park Blvd Ste 210E",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207468",
            "country_code": "US",
            "telephone_number": "423-844-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 W Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603837",
            "country_code": "US",
            "telephone_number": "423-224-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Professional Park Dr Ste 31",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046529",
            "country_code": "US",
            "telephone_number": "423-232-6900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEPEW",
        "first_name": "CARISSA",
        "middle_name": "NICHOLE",
        "credential": "DNP, AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "23054",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TN",
            "license": "23054",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ15094400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARISSA",
            "last_name": "MYERS",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Peter Lawrence De Sciscio, DMD
• Barbara A Deacon, NP
• Yirley Del Rio Henao
• Cathy Demanovich, LSW
• Ahmed Enes Demirci, MD
• Ajit Desai
• Rao G Desu, R.PH
• Diane Devito, DC
• Diabest, Inc
• Anthony William Diaz

• Nurse Practitioner in Perth Amboy, NJ
• Providers in Perth Amboy, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.