Individual provider Active NPI

Marygrace Persico Ferrara, APRN-BC

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Teaneck, NJ
National Provider Identifier
1972676526
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
NC70975 Issued in NJ
Practice address
765 Teaneck Rd
Teaneck, NJ 07666-4248
Phone
(201) 833-8180
NPI assigned
Nov 15, 2006
Last updated
Jul 9, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X NC70975 NJ Primary

Addresses

Primary practice location

765 Teaneck Rd
Teaneck, NJ 07666-4248

Mailing address

420 Longview CT
Northvale, NJ 07647-1322
Phone (201) 768-2659

Other identifiers 1

IdentifierTypeStateIssuer
7965605MedicaidNJ

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
I20041229000780 NJ Practitioner - Certified Clinical Nurse Specialist (CNS) 5991763518 Practice locations: Teaneck, NJ

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

121 Cedar LN
Suite 3E
Teaneck, NJ 07666-4457
Phone (201) 833-8180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
NC70975NJMDPsychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Pascack Valley Psychiatric Institute, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1972676526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 LONGVIEW CT",
            "city": "NORTHVALE",
            "state": "NJ",
            "postal_code": "076471322",
            "telephone_number": "201-768-2659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 TEANECK RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664248",
            "telephone_number": "201-833-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRARA",
        "first_name": "MARYGRACE",
        "middle_name": "PERSICO",
        "name_prefix": "Mrs.",
        "credential": "APRN-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "NC70975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7965605",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.