Individual provider Active NPI

Ebube Jon-Emefieh

  • Psychiatric/Mental Health Nurse Practitioner
  • Eatontown, NJ
National Provider Identifier
1790474526
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ01471400 Issued in NJ
Practice address
615 Hope Rd Ste 3B
Eatontown, NJ 07724-1273
Phone
(732) 724-1234
Fax
(732) 532-0801
NPI assigned
May 8, 2023
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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 26NJ01471400 NJ Primary

Addresses

Primary practice location

615 Hope Rd Ste 3B
Eatontown, NJ 07724-1273

Mailing address

615 Hope Rd Ste 3B
Eatontown, NJ 07724-1273
Phone (732) 724-1234

Other practice location 1

74 Brick Blvd Ste 204
Brick, NJ 08723-7984
Phone (732) 832-3444

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
I20241007001346 NJ Practitioner - Nurse Practitioner 5193256733 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stress Care of New Jersey, LLCGroup PAC ID 5294864575, 48 clinicians

Practice addresses (Care Compare)

4122 Hwy 516
Matawan, NJ 07747-7031
Phone (732) 679-4500

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stress Care of New Jersey, LLC CurrentSince Jul 27, 2024 Accepting new patients
Stress Care of New Jersey, LLC CurrentSince Jul 27, 2024 Accepting new patients
Premier Mental & Behavioral Services, Inc Past Accepting new patients

Locations

4122 Route 516
Matawan, NJ 07747
Phone (732) 679-4500

61 Veronica Ave
Somerset, NJ 08873
Phone (732) 679-4500

Organizations & group practices 4

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": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1790474526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 HOPE RD STE 3B",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241273",
            "telephone_number": "732-724-1234",
            "fax_number": "732-532-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 HOPE RD STE 3B",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241273",
            "telephone_number": "732-724-1234",
            "fax_number": "732-532-0801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "74 Brick Blvd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Brick",
            "state": "NJ",
            "postal_code": "087237984",
            "country_code": "US",
            "telephone_number": "732-832-3444",
            "fax_number": "732-532-0801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JON-EMEFIEH",
        "first_name": "EBUBE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01471400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatontown, NJ

Sources for this page

Verify at the official NPI Registry.