Individual provider Active NPI

Vasty Kum, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Union, NJ
National Provider Identifier
1750055703
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01167000 Issued in NJ
Practice address
235 Salem Rd
Union, NJ 07083-9219
Phone
(862) 220-5723
NPI assigned
Aug 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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 26NJ01167000 NJ Primary

Addresses

Primary practice location

235 Salem Rd
Union, NJ 07083-9219

Mailing address

235 Salem Rd
Union, NJ 07083-9219
Phone (862) 220-5723

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
I20220316000652 NJ Practitioner - Nurse Practitioner 1355736059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

700 Airport Rd
Lakewood, NJ 08701-5907
Phone (732) 367-4700

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Behavioral Health of New Jersey, Inc CurrentSince Mar 7, 2022 Accepting new patients
Preferred Behavioral Health of New Jersey CurrentSince Mar 7, 2022 Accepting new patients
Preferred Behavioral Health of New Jersey, Inc. Current Accepting new patients

Locations

700 Airport Rd
Lakewood, NJ 08701
Phone (732) 458-1700

Organizations & group practices 3

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": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1750055703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 SALEM RD",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070839219",
            "telephone_number": "862-220-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 SALEM RD",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070839219",
            "telephone_number": "862-220-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUM",
        "first_name": "VASTY",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01167000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.