Skyheart Medical LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

SKYHEART MEDICAL LLC

Practice address

1126 Dickinson St
Elizabeth, NJ 07201-2404

Phone

(973) 343-5660

Fax

(833) 978-0843

NPI assigned

Jan 29, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Debbie Y Mohammed, NPNPI 1881807774

Title

NP/Owner

Phone

(973) 343-5660

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22878/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Debbie Ysmin Mohammed, DRPH,MS, MPH,

  • Adult Health Nurse Practitioner
  • Newark, NJ
  • NPI 1881807774

  Primary Care

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1972194215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 EAGLE ROCK AVE UNIT 202",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070526801",
            "telephone_number": "973-343-5660",
            "fax_number": "833-978-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 DICKINSON ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072012404",
            "telephone_number": "973-343-5660",
            "fax_number": "833-978-0843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYHEART MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-29",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "MOHAMMED",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "NP/OWNER",
        "authorized_official_telephone_number": "973-343-5660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Primary Care Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.