Individual provider Active NPI

Mary Teresa Desane, APN-BC

  • Adult Psychiatric/Mental Health Registered Nurse
  • Lakewood, NJ
National Provider Identifier
1497058275
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
26NJ00299700 Issued in NJ
Practice address
725 Airport Rd
Lakewood, NJ 08701-5968
Phone
(732) 276-1510
Fax
(732) 363-5537
NPI assigned
Dec 16, 2010
Last updated
Oct 27, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 26NJ00299700 NJ Primary

Addresses

Primary practice location

725 Airport Rd
Lakewood, NJ 08701-5968

Mailing address

4 Upton PL
Ocean, NJ 07712-3708
Phone (732) 922-2078

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
I20110317000718 NJ Practitioner - Nurse Practitioner 5395928022 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Arc of Monmouth, Inc.Group PAC ID 3971640020, 2 clinicians
Centerpath Wellness IncGroup PAC ID 0042368136, 3 clinicians
A Peaceful Mind Mental Health ServicesGroup PAC ID 9335531730, 8 clinicians

Practice addresses (Care Compare)

1158 Wayside Rd
Tinton Falls, NJ 07712-3148
Phone 7324931919881

117 - 119 Roosevelt Ave
Plainfield, NJ 07060-1331
Phone 9087566870633

117 Roosevelt Ave
Suite 119
Plainfield, NJ 07060-1331

41 Village CT
Hazlet, NJ 07730-1535
Phone (908) 297-8849

Merit-based Incentive Payment System (MIPS)

Final score
69.43 of 100Reported as individual
Quality
15.48
Improvement activities
40
Cost
87.74

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
A Peaceful Mind Mental Health Services CurrentSince Jan 1, 2022 Accepting new patients
The Arc of Monmouth, Inc. CurrentSince Feb 15, 2013 Accepting new patients

Locations

41 Village Ct
Hazlet, NJ 07730
Phone (908) 297-8849

1158 Wayside Rd
Tinton Falls, NJ 07712
Phone (732) 493-1919

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": "1292457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1497058275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 UPTON PL",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "077123708",
            "telephone_number": "732-922-2078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 AIRPORT RD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015968",
            "telephone_number": "732-276-1510",
            "fax_number": "732-363-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANE",
        "first_name": "MARY",
        "middle_name": "TERESA",
        "credential": "APN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-16",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NJ",
            "license": "26NJ00299700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.