Individual provider Active NPI

Edward Mogere Nyamwembe, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Irvington, NJ
National Provider Identifier
1790677284
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ15363100 Issued in NJ
Practice address
1767 Manor Dr Apt C
Irvington, NJ 07111-1053
Phone
(862) 576-3598
NPI assigned
Jul 17, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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 PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 26NJ15363100 NJ Primary

Addresses

Primary practice location

1767 Manor Dr Apt C
Irvington, NJ 07111-1053

Mailing address

252 County Road 601
Belle Mead, NJ 08502-3923
Phone (862) 576-3598

Other practice location 1

1767 Manor Dr Apt C
Irvington, NJ 07111-1053
Phone (862) 576-3598

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
I20251210004450 NJ Practitioner - Nurse Practitioner 5991299570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NJ Memory and Behavioral CareGroup PAC ID 7719013267, 71 clinicians

Practice addresses (Care Compare)

14 Ridgedale Ave
Suite 103
Cedar Knolls, NJ 07927-1106
Phone (973) 295-6335

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ15363100NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NJ Memory and Behavioral Care Single Specialty CurrentSince Nov 1, 2025 Accepting new patients

Locations

14 Ridgedale Ave
Ste 103
Cedar Knolls, NJ 07927
Phone (973) 295-6335

575 Route 28
Bldg 2
Raritan, NJ 08869
Phone (973) 295-6335

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": "1752710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1790677284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 COUNTY ROAD 601",
            "city": "BELLE MEAD",
            "state": "NJ",
            "postal_code": "085023923",
            "telephone_number": "862-576-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1767 MANOR DR APT C",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111053",
            "telephone_number": "862-576-3598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1767 Manor Dr Apt C",
            "address_purpose": "LOCATION",
            "city": "Irvington",
            "state": "NJ",
            "postal_code": "071111053",
            "country_code": "US",
            "telephone_number": "862-576-3598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYAMWEMBE",
        "first_name": "EDWARD",
        "middle_name": "MOGERE",
        "name_prefix": "Mr.",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-17",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15363100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvington, NJ

Sources for this page

Verify at the official NPI Registry.