MINDSPACE CLINIC
NPI 1134857642
Nurse Practitioner - Psychiatric/Mental Health in East Orange, NJ
About Mindspace Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MINDSPACE CLINIC (NPI 1134857642) is a healthcare organization registered as a psychiatric/mental health in East Orange, New Jersey and active in the NPI registry since August 2022. The organization lists Lilian Kordie, Provider, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mindspace Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Mindspace Clinic, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mindspace Clinic's NPI number?
The NPI number for Mindspace Clinic is 1134857642. It was assigned to this organization in the NPPES registry on August 11, 2022.
Where is Mindspace Clinic located?
Mindspace Clinic is located at 137 Evegreen Place Suite 1B, East Orange, NJ 07018. The listed phone number is (201) 407-0702.
What is Mindspace Clinic's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Mindspace Clinic enrolled in Medicare?
Yes. Mindspace Clinic is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mindspace Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Mindspace Clinic. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Mindspace Clinic was last updated on August 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mindspace Clinic · NPI 1134857642
Psychiatric/Mental Health organization in East Orange, New Jersey. Organization record, active in the CMS NPPES registry since August 11, 2022.
## Identity
- **NPI:** 1134857642 (Entity type: Organization)
- **Enumerated:** August 11, 2022
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Lilian Kordie, PROVIDER
## Practice location
- **Address:** 137 EVEGREEN PLACE, SUITE 1B, East Orange, NJ 07018-2005
- **Phone:** (201) 407-0702
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 11, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1134857642) · Data from the CMS NPPES public registry.