Individual provider Active NPI

Victor Jerome

  • Psychiatric/Mental Health Nurse Practitioner
  • Englewood, NJ
National Provider Identifier
1912797572
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
F407039 Issued in NY
Practice address
93 E Sheffield Ave
Englewood, NJ 07631-4914
Phone
(201) 681-4967
NPI assigned
May 7, 2025
Last updated
May 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 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 F407039 NY Primary

Addresses

Primary practice location

93 E Sheffield Ave
Englewood, NJ 07631-4914

Mailing address

93 E Sheffield Ave
Englewood, NJ 07631-4914
Phone (201) 681-4967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250828003698 NY Practitioner - Nurse Practitioner 2264933571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

463 Fashion Ave
FL 18
New York, NY 10018-7595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F407039NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Board of Family & Childrens Services Inc Current Accepting new patients
Jewish Board of Family and Children's Services, Inc. Psychiatric/Mental Health CurrentSince Aug 1, 2025 Accepting new patients
Jewish Board of Family and Children's Services, Inc CurrentSince Aug 1, 2025 Accepting new patients

Locations

3600 Jerome Ave
Bronx, NY 10467
Phone (718) 366-8400

1273 53rd St
Brooklyn, NY 11219
Phone (718) 435-5700

2020 Coney Island Ave
Brooklyn, NY 11223
Phone (718) 676-4210

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": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1912797572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 E SHEFFIELD AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314914",
            "telephone_number": "201-681-4967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 E SHEFFIELD AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314914",
            "telephone_number": "201-681-4967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEROME",
        "first_name": "VICTOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-07",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "F407039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.