Individual provider Active NPI

Sashauna V Dapaah

  • Gerontology Nurse Practitioner
  • Lakewood, NJ
National Provider Identifier
1780453530
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ14964900 Issued in NJ
Practice address
685 River Ave
Lakewood, NJ 08701-5288
Phone
(732) 486-7373
NPI assigned
Dec 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X 26NJ14964900 NJ
Gerontology Nurse Practitioner 363LG0600X 26NJ14964900 NJ Primary

Addresses

Primary practice location

685 River Ave
Lakewood, NJ 08701-5288

Mailing address

380 Hoover Ave Apt 147
Bloomfield, NJ 07003-3979
Phone (908) 400-7016

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
I20240213002108 NJ Practitioner - Nurse Practitioner 9133562580 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Medical Group PCGroup PAC ID 3173049962, 8 clinicians

Practice addresses (Care Compare)

70 S Orange Ave
Suite 235
Livingston, NJ 07039-4915

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ14964900NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal NP Services, LLC Multi-Specialty CurrentSince Feb 1, 2024 Accepting new patients

Locations

685 River Ave
Unit 3
Lakewood, NJ 08701
Phone (732) 987-3855

456 Chestnut St
Ste 102
Lakewood, NJ 08701
Phone (732) 282-7200

Interoperability endpoints

  • Direct secure messaging: sashauna.dapaah.1@32967.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1780453530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 HOOVER AVE APT 147",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070033979",
            "telephone_number": "908-400-7016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 RIVER AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015288",
            "telephone_number": "732-486-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAPAAH",
        "first_name": "SASHAUNA",
        "middle_name": "V",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ14964900",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ14964900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.