Individual provider Active NPI

Alyssa L Nelson, AGNP-C

  • Nurse Practitioner
  • Teaneck, NJ
National Provider Identifier
1821961558
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ15431700 Issued in NJ
Practice address
870 Palisade Ave Ste 302
Teaneck, NJ 07666-3446
Phone
(201) 836-9696
NPI assigned
Sep 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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 Practitioner 363LA2200X 26NJ15431700 NJ
Nurse Practitioner 363L00000X 26NJ15431700 NJ Primary

Addresses

Primary practice location

870 Palisade Ave Ste 302
Teaneck, NJ 07666-3446

Mailing address

870 Palisade Ave Ste 302
Teaneck, NJ 07666-3446
Phone (201) 836-9696

Other practice location 1

82 E Allendale Rd Ste 8A
Saddle River, NJ 07458-3057
Phone (201) 350-5300

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
I20260219004703 NJ Practitioner - Nurse Practitioner 9234626797 Reassigns benefits to 2 organizations

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
Gangaram RagiGroup PAC ID 6901064757, 5 clinicians

Practice addresses (Care Compare)

870 Palisade Ave
Suite 302
Teaneck, NJ 07666-3446
Phone (201) 836-9696

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ15431700NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Skin Cancer & Mohs Surgery LLC CurrentSince Jan 11, 2026 Accepting new patients
Gangaram Ragi CurrentSince Jan 11, 2026 Accepting new patients

Locations

82 E Allendale Rd
Ste 8A
Saddle River, NJ 07458
Phone (201) 350-5300

870 Palisade Ave
Ste 302
Teaneck, NJ 07666
Phone (201) 836-9696

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": "1759104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1821961558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 PALISADE AVE STE 302",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663446",
            "telephone_number": "201-836-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 PALISADE AVE STE 302",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663446",
            "telephone_number": "201-836-9696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "82 E Allendale Rd Ste 8A",
            "address_purpose": "LOCATION",
            "city": "Saddle River",
            "state": "NJ",
            "postal_code": "074583057",
            "country_code": "US",
            "telephone_number": "201-350-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ALYSSA",
        "middle_name": "L",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-29",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ15431700",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ15431700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.