Lukresia B Kawira

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ01314900 Issued in NJ

Practice address

33 Wood Ave S Ste 600
Iselin, NJ 08830-2717

Phone

(908) 565-1320

Fax

(732) 997-0709

NPI assigned

Aug 10, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1932837788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 WOOD AVE S STE 600",
            "city": "ISELIN",
            "state": "NJ",
            "postal_code": "088302717",
            "telephone_number": "908-565-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 WOOD AVE S STE 600",
            "city": "ISELIN",
            "state": "NJ",
            "postal_code": "088302717",
            "telephone_number": "908-565-1320",
            "fax_number": "732-997-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWIRA",
        "first_name": "LUKRESIA",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ01314900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE NURSE",
            "identifier": "26NJ01314900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mohammed Khedr
• Tamara Khutorskoy, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Iselin, NJ
• Providers in Iselin, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.