Individual provider Active NPI

Kylee Gonzalez, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Freehold, NJ
National Provider Identifier
1588029730
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ00846600 Issued in NJ
Practice address
22 Court St
Freehold, NJ 07728-1700
Phone
(732) 780-7387
NPI assigned
Dec 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 646542 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ00846600 NJ Primary

Addresses

Primary practice location

22 Court St
Freehold, NJ 07728-1700

Mailing address

22 Court St
Freehold, NJ 07728-1700
Phone (732) 780-7387

Other names 1

  • Kylee L Stahlnecker Former name

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
I20181105001018 NJ Practitioner - Nurse Practitioner 7810240025 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
646542NYMDRegistered Nurse
26NJ00846600NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CPC Behavioral Healthcare, Inc CurrentSince Sep 12, 2018 Accepting new patients
Roseville Medical Society LLC CurrentSince Apr 17, 2020 Accepting new patients
Salerno Medical Associates, LLC CurrentSince Apr 1, 2020 Accepting new patients
CPC Integrated Health, Inc. CurrentSince Sep 12, 2018 Accepting new patients
Call to Care LLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

613 Park Ave
East Orange, NJ 07017
Phone (973) 672-2455

613 Park Ave
Fl 2
East Orange, NJ 07017
Phone (973) 485-6433

613 Park Ave
Fl 1
East Orange, NJ 07017
Phone (973) 556-0955

10 Industrial Way E
Eatontown, NJ 07724
Phone (732) 935-2220

22 Court St
Freehold, NJ 07728
Phone (732) 780-7387

346 Roseville Ave
Newark, NJ 07107
Phone (973) 482-7245

485 Mount Prospect Ave
Fl 1
Newark, NJ 07104
Phone (973) 485-6433

523 Park Ave
Orange, NJ 07050
Phone (862) 229-1516

Interoperability endpoints

  • Direct secure messaging: kylee.gonzalez.p1@direct.cfg.nextgenshare.com

Organizations & group practices 5

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": "1450137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1588029730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 COURT ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077281700",
            "telephone_number": "732-780-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 COURT ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077281700",
            "telephone_number": "732-780-7387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "KYLEE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-15",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "646542",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00846600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLEE",
            "last_name": "STAHLNECKER",
            "middle_name": "L",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.