Individual provider Active NPI

Latiema Merilus, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Wood Ridge, NJ
National Provider Identifier
1720769953
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ14918600 Issued in NJ
Practice address
6 Wesmont Dr
Wood Ridge, NJ 07075-2152
Phone
(201) 500-6992
Fax
(833) 605-4359
NPI assigned
Jul 31, 2023
Last updated
Apr 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 405146 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ14918600 NJ Primary

Addresses

Primary practice location

6 Wesmont Dr
Wood Ridge, NJ 07075-2152

Mailing address

99 Wall St Ste 1571
New York, NY 10005-4301
Phone (646) 420-7824

Other practice location 1

937 Fulton St
Brooklyn, NY 11238-2347
Phone (718) 260-2900

Other identifiers 1

IdentifierTypeStateIssuer
1049666MedicaidNJ

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
I20250326004020 NJ Practitioner - Nurse Practitioner 3678096039 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
405146NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Uzar PC Single Specialty CurrentSince Mar 1, 2025 Accepting new patients
Mental Armor Psychiatric Services of New York & New Jersey LLC Single Specialty CurrentSince Apr 27, 2025 Accepting new patients

Locations

1400 Hooper Ave
Ste 2
Toms River, NJ 08753
Phone (732) 339-3398

5308 13th Ave
Ste 558
Brooklyn, NY 11219

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": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1720769953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 WALL ST STE 1571",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100054301",
            "telephone_number": "646-420-7824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WESMONT DR",
            "city": "WOOD RIDGE",
            "state": "NJ",
            "postal_code": "070752152",
            "telephone_number": "201-500-6992",
            "fax_number": "833-605-4359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "937 Fulton St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112382347",
            "country_code": "US",
            "telephone_number": "718-260-2900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERILUS",
        "first_name": "LATIEMA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "405146",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ14918600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1049666",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wood Ridge, NJ

Sources for this page

Verify at the official NPI Registry.