Individual provider Active NPI

Samantha Marie D'Averso, MSN, RN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Long Branch, NJ
National Provider Identifier
1891592291
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
26NJ15271000 Issued in NJ
Practice address
75 N Bath Ave
Long Branch, NJ 07740-6317
Phone
(732) 923-6500
NPI assigned
Feb 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 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 Practitioner 363LP0808X 26NJ15271000 NJ Primary

Addresses

Primary practice location

75 N Bath Ave
Long Branch, NJ 07740-6317

Mailing address

75 N Bath Ave
Long Branch, NJ 07740-6317
Phone (732) 923-6500

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
I20260209003542 NJ Practitioner - Nurse Practitioner 8527547603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 W Gilbert St
Tinton Falls, NJ 07701-4948

Hospital & facility affiliations

  • Monmouth Medical Center Hospital, Long Branch, NJ, CCN 310075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NJ15271000NJMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group, PC CurrentSince Dec 29, 2025 Accepting new patients

Locations

75 N Bath Ave
Long Branch, NJ 07740
Phone (732) 923-5231

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

266 King George Rd
Warren, NJ 07059
Phone (732) 667-7778

223 Monmouth Rd
West Long Branch, NJ 07764
Phone (732) 229-3838

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1740441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1891592291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 N BATH AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406317",
            "telephone_number": "732-923-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 N BATH AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406317",
            "telephone_number": "732-923-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AVERSO",
        "first_name": "SAMANTHA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSN, RN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-25",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15271000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Branch, NJ

Sources for this page

Verify at the official NPI Registry.