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MS. KELLY NUSSBAUM APRN
NPI 1215229596
Clinical Nurse Specialist - Psychiatric/Mental Health, Adult in Englewood, NJ

Active since May 05, 2011PECOS EnrolledAccepts Medicare Assignment
163 ENGLE ST STE 4A, ENGLEWOOD, NJ 07631(201) 408-4487(800) 352-3015 Get Directions Write a Review

NPPES record last updated: May 5, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ms. Kelly Nussbaum Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KELLY NUSSBAUM APRN (NPI 1215229596) is an individual psychiatric/mental health, adult provider in Englewood, New Jersey, licensed in New Jersey (26NC07471600) and active in the NPI registry since May 2011. She is enrolled in Medicare PECOS, is affiliated with Saint Michael's Medical Center, and is a graduate of Other (1988).

NPPES Registry Identity

NPI1215229596
Entity TypeIndividualFemale
Primary Taxonomy364SP0809X
Provider Legal NameMS. KELLY NUSSBAUMCredential: APRN
Location Address163 ENGLE ST STE 4AEnglewood, NJ 07631-2530
Mailing Address9 Ricker RdKinnelon, NJ 07405 · (973) 838-8869
Phone(201) 408-4487
Fax(800) 352-3015
Sole ProprietorNo
Medical School CMSOtherGraduated 1988
Enumeration DateMay 5, 2011
✔ NPI 1215229596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical Nurse Specialist · Psychiatric/Mental Health, AdultPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code364SP0809X
License✔ Licensed in NJ · 26NC07471600
163 ENGLE ST STE 4A, Englewood, NJ 07631
Open in Google Maps ↗

Other Names 1

Former Name (1)Ms. Kelly Nussbaum Rn

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Kelly Nussbaum Aprn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052569639
PECOS Enrollment IDI20120925000036
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Saint Michael's Medical Center

Acute Care Hospitals · Newark, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310096
Location111 Central AvenueNewark, NJ 07102 · Essex County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07631 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$111.57 typical visit price
range $20.97 – $155.92
Typical copayment $27.89 (range $5.24 – $38.98)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Kelly Nussbaum's NPI number?

The NPI number for Kelly Nussbaum is 1215229596. It was assigned to this individual provider in the NPPES registry on May 5, 2011. The provider is also known as Ms. Kelly Nussbaum Rn.

Where is Kelly Nussbaum located?

Kelly Nussbaum practices at 163 Engle St Ste 4A, Englewood, NJ 07631. The listed phone number is (201) 408-4487.

What is Kelly Nussbaum's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist, specializing in Psychiatric/Mental Health, Adult, with taxonomy code 364SP0809X.

Is Kelly Nussbaum enrolled in Medicare?

Yes. Kelly Nussbaum is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kelly Nussbaum accept?

Health plans from Providence Health Plan list Kelly Nussbaum as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kelly Nussbaum affiliated with any hospitals?

According to CMS data, Kelly Nussbaum is affiliated with Saint Michael's Medical Center.

When was this NPI record last updated?

The NPPES record for Kelly Nussbaum was last updated on May 5, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.