Individual provider Active NPI

Santa Crisall, RN

  • Gerontology Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1952356149
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
NN71590 Issued in NJ
Practice address
495 N 13TH St
Newark, NJ 07107-1317
Phone
(973) 268-2492
NPI assigned
May 24, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X NN71590 NJ Primary

Addresses

Primary practice location

495 N 13TH St
Newark, NJ 07107-1317

Mailing address

222 Kinderkamack Rd
Oradell, NJ 07649-2259
Phone (973) 268-2492

Other identifiers 1

IdentifierTypeStateIssuer
8459908MedicaidNJ

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
I20050419001001 NJ Practitioner - Nurse Practitioner 0547208779 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harmony Group LLCGroup PAC ID 2769605195, 5 clinicians

Practice addresses (Care Compare)

103 Old Marlton Pike
Suite 203
Medford, NJ 08055-8772
Phone (201) 400-7292

550 Kinderkamack Rd
Suite 124
Oradell, NJ 07649-1500
Phone (201) 400-7292

92 E Main St
Suite 411
Somerville, NJ 08876-2319
Phone (908) 304-5953

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NN71590NJMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Group LLC CurrentSince Mar 1, 2019 Accepting new patients
Holistic Healthcare Services, LLC Gerontology CurrentSince Jan 1, 2017 Accepting new patients
Abbas a. Shehadeh MD, PA Past Accepting new patients

Locations

550 Kinderkamack Rd
Ste 124
Oradell, NJ 07649
Phone (201) 400-7292

92 E Main St
Ste 411
Somerville, NJ 08876
Phone (908) 707-9700

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1952356149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 KINDERKAMACK RD",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "076492259",
            "telephone_number": "973-268-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N 13TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071071317",
            "telephone_number": "973-268-2492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISALL",
        "first_name": "SANTA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2026-07-13",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "NN71590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8459908",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.