Individual provider Active NPI

Marie-Ange Mathis, APN

  • Family Nurse Practitioner
  • Edison, NJ
National Provider Identifier
1639959414
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ14929200 Issued in NJ
Practice address
26 Main St
Edison, NJ 08837-3418
Phone
(609) 358-2622
NPI assigned
Sep 29, 2023
Last updated
Sep 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ14929200 NJ Primary

Addresses

Primary practice location

26 Main St
Edison, NJ 08837-3418

Mailing address

21 Vance Ave
Sicklerville, NJ 08081-2199
Phone (856) 472-4986

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
I20231019000228 NJ Practitioner - Nurse Practitioner 9638524127 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Personal NP Services LLCGroup PAC ID 9335455179, 65 clinicians

Practice addresses (Care Compare)

456 Chestnut St
Suite 102
Lakewood, NJ 08701-6124
Phone (732) 486-7373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ14929200NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Provider Partners Care Management LP CurrentSince Jul 1, 2025 Accepting new patients
Personal NP Services, LLC CurrentSince Jun 1, 2024 Accepting new patients
Patient Care Medical Group PC CurrentSince Oct 18, 2023 Accepting new patients
Vitality NP Group LLC PastSince Jun 1, 2024 Accepting new patients

Locations

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (410) 967-2097

26 Main St
Edison, NJ 08837
Phone (609) 385-2622

456 Chestnut St
Ste 102
Lakewood, NJ 08701
Phone (732) 282-7200

685 River Ave
Unit 3
Lakewood, NJ 08701
Phone (732) 987-3855

170 Changebridge Rd
Bldg C3
Montville, NJ 07045
Phone (973) 575-5540

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": "1695945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1639959414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 VANCE AVE",
            "city": "SICKLERVILLE",
            "state": "NJ",
            "postal_code": "080812199",
            "telephone_number": "856-472-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 MAIN ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088373418",
            "telephone_number": "609-358-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "MARIE-ANGE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-29",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ14929200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.