Salvatore Zullo, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ14955900 Issued in NJ

Practice address

18-20 Lackawanna PLZ Ste 300
Montclair, NJ 07042-3642

Phone

(855) 444-7258

NPI assigned

Nov 21, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, CO2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Moonshot Psychiatric Nurse Practitioner PCGroup PAC ID 9335589696, 79 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.

• Moonshot Psychiatric Nurse Practitioner PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Seattle, WA
  • NPI 1669158879

  CO, NJ

  Medicare reassignment Care Compare group NPD
• Brightway Healthcare LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Philadelphia, PA
  • NPI 1548938996

  NJ

  Medicare reassignment NPD
• Lavender New Jersey Psychiatric Nurse Practitioner PC

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
  • NPI 1629922950
  NPD

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

{
    "created_epoch": "1700524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1710752647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HIGH ST",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080572836",
            "telephone_number": "610-608-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18-20 LACKAWANNA PLZ STE 300",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423642",
            "telephone_number": "855-444-7258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZULLO",
        "first_name": "SALVATORE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ14955900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Zhao
• Xin Zheng
• Robert Ziccardi, DDS
• Katelyn Zima
• Tahani N Zindaki, P.A.
• Kristi Zybulewski, MSW, LSW

• Psychiatric/Mental Health Nurse Practitioner in Montclair, NJ
• Providers in Montclair, 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 Jan 21, 2025; 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.