Individual provider Active NPI

Melanie R Niederhauser, APN

  • Pediatric Nurse Practitioner
  • Mountainside, NJ
National Provider Identifier
1609542737
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
26NJ01191600 Issued in NJ
Practice address
150 New Providence Rd
Mountainside, NJ 07092-2590
Phone
(732) 914-1100
NPI assigned
Aug 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 26NJ01191600 NJ Primary

Addresses

Primary practice location

150 New Providence Rd
Mountainside, NJ 07092-2590

Mailing address

126 Bayview Dr
Brick, NJ 08723-7455
Phone (732) 278-5094

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
I20220408001989 NJ Practitioner - Nurse Practitioner 3678969136 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01191600NJMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children' Specialized Hospital CurrentSince Apr 1, 2022 Accepting new patients
Children'S Specialized Hospital CurrentSince Apr 1, 2022 Accepting new patients

Locations

150 New Providence Rd
Mountainside, NJ 07092

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

94 Stevens Rd
Toms River, NJ 08755
Phone (732) 286-5005

2840 Morris Ave
Union, NJ 07083
Phone (908) 588-9860

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": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1609542737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 BAYVIEW DR",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087237455",
            "telephone_number": "732-278-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 NEW PROVIDENCE RD",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922590",
            "telephone_number": "732-914-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDERHAUSER",
        "first_name": "MELANIE",
        "middle_name": "R",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NJ01191600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountainside, NJ

Sources for this page

Verify at the official NPI Registry.