Obinna Ezealor, APN PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ00760100 Issued in NJ

Practice address

1691 US Highway 9
Toms River, NJ 08755-1245

Phone

(732) 914-1688

NPI assigned

Oct 8, 2017

Last updated

May 7, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Kalm Behavioral Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Neptune, NJ
  • NPI 1386418226
  Medicare reassignment NPD Authorized official
• Barnabas Health Medical Group, PC

  • Specialist
  • West Orange, NJ
  • NPI 1447206420
  Medicare reassignment NPD
• Jewish Family & Children's Service of Greater Monmouth County

  • Clinical Social Worker
  • Asbury Park, NJ
  • NPI 1164540274
  Medicare reassignment
• Sage Wellness Center LLC

  • Clinical Social Worker
  • Toms River, NJ
  • NPI 1669837811
  NPD

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

{
    "created_epoch": "1507420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1487164190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 JEROME ST APT E",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072041448",
            "telephone_number": "908-220-1714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1691 US HIGHWAY 9",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087551245",
            "telephone_number": "732-914-1688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "59 Koch Ave",
            "address_purpose": "LOCATION",
            "city": "Morris Plains",
            "state": "NJ",
            "postal_code": "079504400",
            "country_code": "US",
            "telephone_number": "908-220-1714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3000 Essex Rd",
            "address_purpose": "LOCATION",
            "city": "Tinton Falls",
            "state": "NJ",
            "postal_code": "077532400",
            "country_code": "US",
            "telephone_number": "732-643-2070",
            "fax_number": "732-643-2015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EZEALOR",
        "first_name": "OBINNA",
        "credential": "APN PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-08",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00760100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edamwen Eweka, MD, MBA
• Ewi Therapeutic Services LLC
• Express It of Toms River, LLC
• Express It Speech-Language Pathologists
• Express Medical DME Limited Liability Corporation
• Ezmedsupply LLC
• Janine Fabrizio
• Michael Facciolli, RNFA
• Karissa Facciponte
• Courtney Facendo, LSW

• Psychiatric/Mental Health Nurse Practitioner in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.