Jermaine A Nnaeto, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ14995300 Issued in NJ

Practice address

162 Elmora Ave Ste 416
Elizabeth, NJ 07202-1148

Phone

(908) 488-6003

Fax

(908) 585-4995

NPI assigned

Jan 26, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mind Harbor Psychiatric Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Elizabeth, NJ
  • NPI 1689493793
  Medicare reassignment NPD Authorized official
• Gold Standard Medical Group PC

  • Internal Medicine Physician
  • Clifton, NJ
  • NPI 1043722853
  Medicare reassignment NPD
• NJ Behavioral Health Services PC

  • Clinical Psychologist
  • Paramus, NJ
  • NPI 1447289376

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Che Senior Psychological Services, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1023078219

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Knapp Street Psychiatry, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1043248776

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Orenda Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
  • NPI 1528663945
  Medicare reassignment NPD
• Mind Harbor Nurse Practitioner in Psychiatry Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Brooklyn, NY
  • NPI 1851211874
  NPD Authorized official
• Mind Harbor Psychiatric Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Katy, TX
  • NPI 1518887926
  NPD (past) Authorized official
• Inner Light Mental Health and Addiction Services L.L.C

  • Psychiatric/Mental Health Nurse Practitioner
  • Union, NJ
  • NPI 1124869797
  NPD

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

{
    "created_epoch": "1706227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1962264812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 ELMORA AVE STE 416",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072021148",
            "telephone_number": "908-488-6003",
            "fax_number": "908-585-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 ELMORA AVE STE 416",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072021148",
            "telephone_number": "908-488-6003",
            "fax_number": "908-585-4995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NNAETO",
        "first_name": "JERMAINE",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-26",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ14995300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NJ Med, PA
• NJ Pain Management & Rehab, P.a.
• NJ Sunny Home Care Inc
• NJ Urgentcare
• Nna of Elizabeth, L.L.C.
• Joseph Norowitz, O.D.
• North Broad Pharmacies LLC
• North Jersey Dental
• North Jersey Diagnostic & Pain PA
• Nova New Jersey Physician Group LLC

• Psychiatric/Mental Health Nurse Practitioner in Elizabeth, NJ
• Providers in Elizabeth, 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 Oct 7, 2024; 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.