Elyse Fearon

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

26NJ15226200 Issued in NJ

Practice address

382 W Passaic Ave
Bloomfield, NJ 07003-5554

Phone

(973) 338-1900

NPI assigned

Dec 26, 2024

Last updated

Dec 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John V Kelly MD PCGroup PAC ID 9638106891, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Clara Maass Medical Center Hospital, Belleville, NJ, CCN 310009

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• John V. Kelly MD, PC

  • Internal Medicine Physician
  • Bloomfield, NJ
  • NPI 1417065830
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Clara Maass Medical Center

  • General Acute Care Hospital
  • Belleville, NJ
  • NPI 1902901333
  Care Compare affiliation

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

{
    "created_epoch": "1735171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1720896491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 UNION ST",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091925",
            "telephone_number": "973-908-5563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 W PASSAIC AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070035554",
            "telephone_number": "973-338-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEARON",
        "first_name": "ELYSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-26",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ15226200",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ15226200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hossam Farag
• Eden D Farnum
• Elizabeth Flores Farrell, LCSW
• Humam Farrukh
• Natalie Fattal, APN
• Robert F Fennimore, DC
• Danielle Feuerstein
• First Assistants R.N. Services of New Jersey
• Julia Fischbein, OTR
• John Joseph Florio, D.C.

• Gerontology Nurse Practitioner in Bloomfield, NJ
• Providers in Bloomfield, NJ by specialty
• Gerontology Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; 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.