Evan Douglas Federici, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ15110100 Issued in NJ

Practice address

615 Hope Rd Ste 3B
Eatontown, NJ 07724-1273

Phone

(732) 724-1234

NPI assigned

Aug 7, 2024

Last updated

Apr 13, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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

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.

• Brain Ways LLC

  • Clinic/Center
  • Lawrence, NJ
  • NPI 1801556691

  Single Specialty

  Medicare reassignment NPD
• NP Visits of New Jersey, LLC

  • Adult Health Nurse Practitioner
  • Rockaway, NJ
  • NPI 1154094597

  Single Specialty

  Medicare reassignment NPD
• Premier Mental & Behavioral Services, Inc

  dba Positive Reset Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Eatontown, NJ
  • NPI 1114599305

  Single Specialty

  Medicare reassignment NPD
• Premier Mental & Behavioral Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brick, NJ
  • NPI 1649958372
  NPD

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

{
    "created_epoch": "1722988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744502400000",
    "number": "1598595159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 HOPE RD STE 3B",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241273",
            "telephone_number": "732-724-1234",
            "fax_number": "732-532-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 HOPE RD STE 3B",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241273",
            "telephone_number": "732-724-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 Marina Dr Apt L",
            "address_purpose": "LOCATION",
            "city": "Edison",
            "state": "NJ",
            "postal_code": "088176145",
            "country_code": "US",
            "telephone_number": "973-376-0002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEDERICI",
        "first_name": "EVAN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-07",
        "last_updated": "2025-04-13",
        "certification_date": "2025-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NR20562100",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15110100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenell Marie Evangelista, LAC
• Salman Farooqui, OD
• Megan Elizabeth Farrell, FNP
• Danielle Faul
• Allison Fayans, PA-C
• Gregory Gerard Fedorcik, MD
• Robert J Fegan, MD
• Cara Fehnel, APN
• Joni Feldbaum-Smith, O.D.
• Joanna Feliz

• Psychiatric/Mental Health Nurse Practitioner in Eatontown, NJ
• Providers in Eatontown, 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 Apr 13, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.