Kristina Way, AGPCNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

404316 Issued in NY

Practice address

614 Pennsylvania Ave Apt 2
Elizabeth, NJ 07201-1265

Phone

(973) 592-5750

NPI assigned

Aug 26, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psychiatry on Video LLCGroup PAC ID 6800269432, 6 clinicians

Premier Psychiatric Consultants, LLCGroup PAC ID 7315077120, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Premier Psychiatric Consultants LLC

  • Adult Mental Health Clinic/Center
  • West New York, NJ
  • NPI 1508182072

  NJ

  Medicare reassignment Care Compare group NPD
• Psychiatry on Video LLC

  • Psychiatry Physician
  • Ridgewood, NJ
  • NPI 1700532587

  NJ

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1952020406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 PENNSYLVANIA AVE APT 2",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072011265",
            "telephone_number": "973-592-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 PENNSYLVANIA AVE APT 2",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072011265",
            "telephone_number": "973-592-5750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 E Ridgewood Ave",
            "address_purpose": "LOCATION",
            "city": "Ridgewood",
            "state": "NJ",
            "postal_code": "074503865",
            "country_code": "US",
            "telephone_number": "201-470-4006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAY",
        "first_name": "KRISTINA",
        "credential": "AGPCNP, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-26",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309685",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Eastern Co, Inc
• Walgreens Health Services LLC
• Jasjit Walia, M.D
• Amy Walshver
• Shule Wang
• Nella Weaver, WHNP
• Rebecca Weinberger
• Scott Weiss, LCSW
• Laura Weitzman
• Wellspine,LLC

• All providers in Elizabeth, NJ
• 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 May 4, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.