NASHANDA BALOGUN AGPCNP
NPI 1417365776
Nurse Practitioner - Gerontology in Montclair, NJ

Q: What is Nashanda Balogun's NPI number?

The NPI number for Nashanda Balogun is 1417365776. It was assigned to this individual provider in the NPPES registry on July 30, 2014.

Q: What is Nashanda Balogun's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Q: When was this NPI record last updated?

The NPPES record for Nashanda Balogun was last updated on January 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.

Active since July 30, 2014PECOS EnrolledAccepts Medicare Assignment

28 VALLEY RD # 148, MONTCLAIR, NJ 07042(973) 559-4600(855) 998-4358 Get Directions Write a Review

NPPES record last updated: January 13, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 7, 2025, Aug 9, 2021, Mar 17, 2018 and 1 more (4 updates tracked since 2017).

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About Nashanda Balogun Agpcnp NPPES

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

NASHANDA BALOGUN AGPCNP (NPI 1417365776) is an individual gerontology provider in Montclair, New Jersey, licensed in New Jersey (26NJ15053300) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1417365776

Entity TypeIndividualFemale

Primary Taxonomy363LG0600X

Provider Legal NameNASHANDA BALOGUNCredential: AGPCNP

Location Address28 VALLEY RD # 148Montclair, NJ 07042-2709

Mailing Address28 Valley Rd # 148Montclair, NJ 07042-2709 · (973) 559-4600 · Fax (855) 998-4358

Phone(973) 559-4600

Fax(855) 998-4358

Sole ProprietorYes

Medical School CMSOtherGraduated 2016

Enumeration DateJuly 30, 2014

Last NPPES UpdateJanuary 13, 20254 updates tracked since enumeration

NPPES CertifiedJanuary 13, 2025

✔ NPI 1417365776 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LG0600X

License✔ Licensed in NJ · 26NJ15053300

Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License SP013879 (PA)

Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X · License SP013879 (PA)

28 VALLEY RD # 148, Montclair, NJ 07042

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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

Nashanda Balogun Agpcnp 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 ID9931576949

PECOS Enrollment IDI20240718001359

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07042 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

$98.09 typical visit price

range $63.84 – $190.92

Typical copayment $24.52 (range $15.96 – $47.73)

Most-billed visit code 99203

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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. MICHELLE GILES-HONORE APN

Nurse Practitioner (Family)