Kimberly Colangelo, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ01408300 Issued in NJ

Practice address

1550 Park Ave Ste 102
South Plainfield, NJ 07080-5565

Phone

(609) 890-1050

Fax

(609) 890-0950

NPI assigned

Jan 28, 2020

Sex

Female

Sole proprietor

No

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 NY

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blue Skies Psychological Services, P.C.Group PAC ID 9638601933, 2 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Blue Skies Psychological Services, P.C.

  • Clinical Psychologist
  • Staten Island, NY
  • NPI 1598306961

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Richmond Behavioral Wellness Physician PLLC

  • Psychiatry Physician
  • Staten Island, NY
  • NPI 1598583494
  NPD (past)

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1659902831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 PARK AVE STE 102",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070805565",
            "telephone_number": "609-594-5827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 PARK AVE STE 102",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070805565",
            "telephone_number": "609-890-1050",
            "fax_number": "609-890-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 Forest Ave",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103102520",
            "country_code": "US",
            "telephone_number": "347-464-5550",
            "fax_number": "347-464-5550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLANGELO",
        "first_name": "KIMBERLY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-28",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402906",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01408300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angel Cisson
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• Dominique N Cole, LAMFT, BS, CLC, CPC
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• Psychiatric/Mental Health Nurse Practitioner in South Plainfield, NJ
• Providers in South Plainfield, 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 Jul 17, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.