Individual provider Active NPI

Krystle Sherelle Kush, AGNP-C

  • Primary Care Nurse Practitioner
  • North Arlington, NJ
National Provider Identifier
1730069436
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
26NJ15400300 Issued in NJ
Practice address
25 Locust Ave
North Arlington, NJ 07031-5512
Phone
(201) 246-1111
NPI assigned
Sep 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ15400300 NJ
Primary Care Nurse Practitioner 363LP2300X 26NJ15400300 NJ Primary

Addresses

Primary practice location

25 Locust Ave
North Arlington, NJ 07031-5512

Mailing address

25 Locust Ave
North Arlington, NJ 07031-5512
Phone (201) 246-1111

Other practice location 1

181 Franklin Ave Ste 304
Nutley, NJ 07110-2900
Phone (973) 743-2455

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
I20260603000405 NJ Practitioner - Nurse Practitioner 2365913100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8 Wolfe Dr
Wanaque, NJ 07465-1024

816 Kearny Ave
Kearny, NJ 07032-3148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ15400300NJMDGerontology Nurse Practitioner

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1730069436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 LOCUST AVE",
            "city": "NORTH ARLINGTON",
            "state": "NJ",
            "postal_code": "070315512",
            "telephone_number": "201-246-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 LOCUST AVE",
            "city": "NORTH ARLINGTON",
            "state": "NJ",
            "postal_code": "070315512",
            "telephone_number": "201-246-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "181 Franklin Ave Ste 304",
            "address_purpose": "LOCATION",
            "city": "Nutley",
            "state": "NJ",
            "postal_code": "071102900",
            "country_code": "US",
            "telephone_number": "973-743-2455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUSH",
        "first_name": "KRYSTLE",
        "middle_name": "SHERELLE",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ15400300",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ15400300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Arlington, NJ

Sources for this page

Verify at the official NPI Registry.