Individual provider Active NPI

Edna Wireko, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Irvington, NJ
National Provider Identifier
1700763414
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ15210700 Issued in NJ
Practice address
729 Springfield Ave
Irvington, NJ 07111-3623
Phone
(908) 884-7710
NPI assigned
Aug 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 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 26NJ15210700 NJ Primary

Addresses

Primary practice location

729 Springfield Ave
Irvington, NJ 07111-3623

Mailing address

729 Springfield Ave
Irvington, NJ 07111-3623

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
I20260217004397 NJ Practitioner - Nurse Practitioner 2365922309 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

402 Main St
Suite 214
Metuchen, NJ 08840-1899

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ15210700NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Positive Impact Behavioral Health Services Psychiatric/Mental Health CurrentSince Jan 6, 2026 Accepting new patients

Locations

402 Main St
Ste 214
Metuchen, NJ 08840
Phone (848) 252-8625

Organizations & group practices 1

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": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1700763414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 SPRINGFIELD AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 SPRINGFIELD AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113623",
            "telephone_number": "908-884-7710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIREKO",
        "first_name": "EDNA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15210700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvington, NJ

Sources for this page

Verify at the official NPI Registry.