Individual provider Active NPI

Nicholas Gichuki Mwangi, APN

  • Psychiatric/Mental Health Registered Nurse
  • Springfield, NJ
National Provider Identifier
1851967525
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
26NJ01147600 Issued in NJ
Practice address
195 Mountain Ave
Springfield, NJ 07081-1755
Phone
(973) 295-6335
NPI assigned
Jun 2, 2021
Last updated
Jun 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 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 Registered Nurse 163WP0808X 26NJ01147600 NJ Primary

Addresses

Primary practice location

195 Mountain Ave
Springfield, NJ 07081-1755

Mailing address

52 Hoy Ave
Fords, NJ 08863-1942
Phone (732) 986-7389

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Springfield

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
I20210610000417 NJ Practitioner - Nurse Practitioner 8628478864 Reassigns benefits to 2 organizations

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
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

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

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Mental & Behavioral Services, Inc CurrentSince Mar 6, 2023 Accepting new patients
NJ Memory and Behavioral Care CurrentSince Jun 1, 2021 Accepting new patients
Premier Mental & Behavioral Services, Inc CurrentSince Mar 6, 2023 Accepting new patients

Locations

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

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

195 Mountain Ave
Springfield, NJ 07081
Phone (973) 295-6335

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, 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": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1851967525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 HOY AVE",
            "city": "FORDS",
            "state": "NJ",
            "postal_code": "088631942",
            "telephone_number": "732-986-7389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 MOUNTAIN AVE",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811755",
            "telephone_number": "973-295-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MWANGI",
        "first_name": "NICHOLAS",
        "middle_name": "GICHUKI",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01147600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Springfield",
            "affiliation": "N",
            "endpointDescription": "home",
            "address_1": "195 Mountain Ave",
            "city": "Springfield",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070811755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, NJ

Sources for this page

Verify at the official NPI Registry.