Individual provider Active NPI

Brianna Scancarella, PMHNP, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Sparta, NJ
National Provider Identifier
1548643430
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00659400 Issued in NJ
Practice address
55 Skyline Dr
Sparta, NJ 07871-3434
Phone
(973) 435-6331
Fax
(973) 435-6652
NPI assigned
Jul 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 26NJ00659400 NJ Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NR18605800 NJ

Addresses

Primary practice location

55 Skyline Dr
Sparta, NJ 07871-3434

Mailing address

130 Powerville Rd
Boonton, NJ 07005-8705

Other identifiers 1

IdentifierTypeStateIssuer
1548643430OtherNONE

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
I20180615000447 NJ Practitioner - Nurse Practitioner 6406101419 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00659400NJMDPsychiatric/Mental Health Nurse Practitioner
26NR18605800NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Services - Saint Clare'S LLC Single Specialty CurrentSince Aug 6, 2018 Accepting new patients
Prime Healthcare Services - Saint Clare'S LLC CurrentSince Aug 6, 2018 Accepting new patients

Locations

130 Powerville Rd
Boonton Twp, NJ 07005
Phone (973) 316-1800

25 Pocono Rd
Denville, NJ 07834
Phone (273) 625-6000

Interoperability endpoints

  • Direct secure messaging: brianna.scancarella.p1@direct.cfg.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1548643430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 POWERVILLE RD",
            "city": "BOONTON",
            "state": "NJ",
            "postal_code": "070058705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SKYLINE DR",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078713434",
            "telephone_number": "973-435-6331",
            "fax_number": "973-435-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANCARELLA",
        "first_name": "BRIANNA",
        "credential": "PMHNP,  RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-09",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00659400",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NR18605800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "1548643430",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, NJ

Sources for this page

Verify at the official NPI Registry.