Individual provider Active NPI

Falecia Andino, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1689484016
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ15071100 Issued in NJ
Practice address
550 Broad St Ste 606
Newark, NJ 07102-4537
Phone
(201) 822-1161
NPI assigned
Jan 8, 2025
Last updated
Jan 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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 Practitioner 363LP0808X 26NJ15071100 NJ Primary

Addresses

Primary practice location

550 Broad St Ste 606
Newark, NJ 07102-4537

Mailing address

550 Broad St Ste 606
Newark, NJ 07102-4537
Phone (201) 822-1161

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
I20250220003126 NJ Practitioner - Nurse Practitioner 1254851264 Reassigns benefits to 1 organization

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
JLS Medical PCGroup PAC ID 7719342005, 53 clinicians

Practice addresses (Care Compare)

550 Broad St
Suite 606
Newark, NJ 07102-4537
Phone (201) 822-1161

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
JLS Medical PC Single Specialty CurrentSince Dec 5, 2024 Accepting new patients
Bancroft, a New Jersey Nonprofit Corporation Single Specialty PastSince Dec 5, 2024 Accepting new patients

Locations

550 Broad St
Ste 606
Newark, NJ 07102
Phone (425) 458-8525

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, 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": "1736294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1689484016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 BROAD ST STE 606",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071024537",
            "telephone_number": "201-822-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 BROAD ST STE 606",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071024537",
            "telephone_number": "201-822-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDINO",
        "first_name": "FALECIA",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15071100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.