Individual provider Active NPI

Michelle R Cicala, MSN, APN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Paramus, NJ
National Provider Identifier
1689389447
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01424800 Issued in NJ
Practice address
351 Evelyn St
Paramus, NJ 07652-2901
Phone
(201) 977-2889
NPI assigned
Jan 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 26NJ01424800 NJ Primary

Addresses

Primary practice location

351 Evelyn St
Paramus, NJ 07652-2901

Mailing address

51 Greendale Rd
Cedar Grove, NJ 07009-1312
Phone (973) 865-1912

Other practice location 1

Life Back
4 Princess Road
Lawrenceville, NJ 08648
Phone (609) 482-3701

Other names 1

  • Michelle Cicala Professional 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
I20241031001660 NJ Practitioner - Nurse Practitioner 5294268025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Helene Miller MD LLCGroup PAC ID 8224465927, 9 clinicians

Practice addresses (Care Compare)

17 Arcadian Way
Suite 108
Paramus, NJ 07652-1245

351 Evelyn St
Paramus, NJ 07652-2901
Phone (201) 977-2889

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ01424800NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Helene Miller, MD, LLC Single Specialty CurrentSince Aug 22, 2024 Accepting new patients
Medica Mental Health PastSince Aug 11, 2024 Accepting new patients

Locations

351 Evelyn St
Paramus, NJ 07652
Phone (201) 265-1300

351 Evelyn St
Fl 3
Paramus, NJ 07652
Phone (201) 265-3111

17 Arcadian Way
Ste 108
Paramus, NJ 07652
Phone (201) 316-5581

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": "1673913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1689389447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 GREENDALE RD",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091312",
            "telephone_number": "973-865-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 EVELYN ST",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076522901",
            "telephone_number": "201-977-2889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "LIFE BACK",
            "address_2": "4 PRINCESS ROAD",
            "address_purpose": "LOCATION",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "08648",
            "country_code": "US",
            "telephone_number": "609-482-3701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CICALA",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "MSN, APN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-17",
        "last_updated": "2024-11-19",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01424800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "CICALA",
            "credential": "MSN, APN, PMHNP-BC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Paramus, NJ

Sources for this page

Verify at the official NPI Registry.