Individual provider Active NPI

Justine E Samson

  • Nurse Practitioner
  • Lakewood, NJ
National Provider Identifier
1932065323
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ15263300 Issued in NJ
Practice address
456 Chestnut St
Lakewood, NJ 08701-6124
Phone
(732) 282-7200
Fax
(732) 292-7300
NPI assigned
Dec 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ15263300 NJ Primary

Addresses

Primary practice location

456 Chestnut St
Lakewood, NJ 08701-6124

Mailing address

456 Chestnut St
Lakewood, NJ 08701-6124
Phone (732) 282-7200

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
I20260203000001 NJ Practitioner - Nurse Practitioner 5698253466 Reassigns benefits to 1 organization

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
Personal NP Services LLCGroup PAC ID 9335455179, 65 clinicians

Practice addresses (Care Compare)

456 Chestnut St
Suite 102
Lakewood, NJ 08701-6124
Phone (732) 486-7373

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ15263300NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal NP Services, LLC Nurse Practitioner CurrentSince Jan 1, 2026 Accepting new patients

Locations

685 River Ave
Unit 3
Lakewood, NJ 08701
Phone (732) 987-3855

456 Chestnut St
Ste 102
Lakewood, NJ 08701
Phone (732) 282-7200

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.

NPI Registry JSON

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

{
    "created_epoch": "1766966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1932065323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 CHESTNUT ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087016124",
            "telephone_number": "732-282-7200",
            "fax_number": "732-282-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 CHESTNUT ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087016124",
            "telephone_number": "732-282-7200",
            "fax_number": "732-292-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMSON",
        "first_name": "JUSTINE",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-29",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ15263300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.