Individual provider Active NPI

Yitzchok Mehlman, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lakewood, NJ
National Provider Identifier
1558162255
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ15282600 Issued in NJ
Practice address
1771 Madison Ave
Lakewood, NJ 08701-1242
Phone
(732) 364-6666
NPI assigned
Mar 20, 2025
Last updated
Mar 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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 26NJ15282600 NJ Primary

Addresses

Primary practice location

1771 Madison Ave
Lakewood, NJ 08701-1242

Mailing address

1771 Madison Ave
Lakewood, NJ 08701-1242

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
I20250710002614 NJ Practitioner - Nurse Practitioner 6002320918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1771 Madison Ave
Lakewood, NJ 08701-1251

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ15282600NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Resource and Referral Center Inc Current Accepting new patients
Lakewood Resource and Referral Center, Inc. CurrentSince Jun 1, 2025 Accepting new patients
Lakewood Resource and Referral Center, Inc. CurrentSince Jun 1, 2025 Accepting new patients
Lakewood Resource and Referral Center Inc Past Accepting new patients

Locations

1771 Madison Ave
Lakewood, NJ 08701
Phone (732) 364-2144

Organizations & group practices 4

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": "1742428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1558162255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087011242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087011242",
            "telephone_number": "732-364-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHLMAN",
        "first_name": "YITZCHOK",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-20",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15282600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.