Individual provider Active NPI

Collete Nyanaro

  • Psychiatric/Mental Health Nurse Practitioner
  • Marlton, NJ
National Provider Identifier
1871373670
Registry record updated Oct 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ14849700 Issued in NJ
Practice address
78 Kent Ave
Marlton, NJ 08053-1830
Phone
(973) 687-2840
NPI assigned
Sep 29, 2023
Last updated
Oct 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 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 26NJ14849700 NJ Primary

Addresses

Primary practice location

78 Kent Ave
Marlton, NJ 08053-1830

Mailing address

80 Van Ness Ter
Maplewood, NJ 07040-3344
Phone (973) 687-2840

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
I20231205000050 NJ Practitioner - Nurse Practitioner 5698123438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
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

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

State licenses

LicenseStateTypeSpecialty
26NJ14849700NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
NJ Memory and Behavioral Care CurrentSince Nov 20, 2023 Accepting new patients

Locations

14 Ridgedale Ave
Ste 103
Cedar Knolls, NJ 07927
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": "1695945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791590400000",
    "number": "1871373670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 VAN NESS TER",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403344",
            "telephone_number": "973-687-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 KENT AVE",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531830",
            "telephone_number": "973-687-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYANARO",
        "first_name": "COLLETE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-29",
        "last_updated": "2026-10-10",
        "certification_date": "2026-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ14849700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.