MS. IDALISSIE ALTAGRACIA PEGUERO APN, PMHNPBC
NPI 1689154437
Nurse Practitioner - Psychiatric/Mental Health in Newark, NJ
About Ms. Idalissie Altagracia Peguero Apn, Pmhnpbc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. IDALISSIE ALTAGRACIA PEGUERO APN, PMHNPBC (NPI 1689154437) is an individual psychiatric/mental health provider in Newark, New Jersey, licensed in New Jersey (26NJ00838200) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS, maintains a secondary practice location in Paterson, and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Ms. Idalissie Altagracia Peguero Apn, Pmhnpbc 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.
Medicare Billing Reassignments
4Medicare enrollment records show Idalissie Peguero reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Newark, NJ 07102
- Reassigned Medicare billing, New Jersey enrollment
- 141 clinicians in this Medicare group
Bloomfield, NJ 07003
- Reassigned Medicare billing, New Jersey enrollment
- 76 clinicians in this Medicare group
Hoboken, NJ 07030
- Reassigned Medicare billing, New Jersey enrollment
- 673 clinicians in this Medicare group
Paterson, NJ 07514
- Reassigned Medicare billing, New Jersey enrollment
- 40 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 07102 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
NEWARK, NJ 07102
NEWARK, NJ 07102
NEWARK, NJ 07102
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 Idalissie Peguero's NPI number?
The NPI number for Idalissie Peguero is 1689154437. It was assigned to this individual provider in the NPPES registry on August 20, 2018.
Where is Idalissie Peguero located?
Idalissie Peguero practices at 550 Broad St Ste 606, Newark, NJ 07102. The listed phone number is (201) 822-1161.
What is Idalissie Peguero's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Idalissie Peguero enrolled in Medicare?
Yes. Idalissie Peguero 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.
Which organizations bill Medicare for Idalissie Peguero's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Idalissie Peguero reassigns Medicare benefits to 4 organizations: Jls Medical PC (Newark, NJ), Care Plus Nj, Inc (Bloomfield, NJ), Grow Healthcare Group Of New Jersey PC (Hoboken, NJ) and G & s Medical Associates LLC (Paterson, NJ). Each 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 Idalissie Peguero's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Idalissie Peguero was last updated on October 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Ms. Idalissie Altagracia Peguero, APN, PMHNPBC · NPI 1689154437
Psychiatric/Mental Health physician in Newark, New Jersey. Individual provider, active in the CMS NPPES registry since August 20, 2018.
## Identity
- **NPI:** 1689154437 (Entity type: Individual)
- **Enumerated:** August 20, 2018
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 26NJ00838200 (New Jersey)
- **Sole proprietor:** No
## Practice location
- **Address:** 550 BROAD ST STE 606, Newark, NJ 07102-4537
- **Phone:** (201) 822-1161 · **Fax:** (877) 485-8918
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Jls Medical PC (NPI 1164007043, Newark, NJ); Care Plus Nj, Inc (NPI 1992822118, Bloomfield, NJ); Grow Healthcare Group Of New Jersey PC (NPI 1841949328, Hoboken, NJ); G & s Medical Associates LLC (NPI 1982982336, Paterson, NJ) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** October 10, 2024
- **Other identifiers:** Medicaid 0655881 (NJ)
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Source: [NPI Profile](https://npiprofile.com/npi/1689154437) · Data from the CMS NPPES public registry.