Shandel Douglas, APN in East Orange, NJ - Medicare Nurse Practitioner

Shandel Douglas, APN is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in East Orange, New Jersey. Her current practice location is 310 Central Avenue, Suite 102, East Orange, New Jersey. You can reach out to her office (for appointments etc.) via phone at (973) 395-1550.

Shandel Douglas is licensed to practice in New Jersey (license number 26NJ00747600) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1649798455.

Contact Information

	Shandel Douglas, APN
	310 Central Avenue, Suite 102, East Orange, NJ 07018
	(973) 395-1550
	(973) 395-1556

Map and Direction

Provider's Profile

Full Name	Shandel Douglas
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	310 Central Avenue, East Orange, New Jersey
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1649798455
Provider Enumeration Date: 08/31/2017
Last Update Date: 09/30/2025

Medicare PECOS Information:

PECOS PAC ID: 7012273790
Enrollment ID: I20171113003306

Medical Identifiers

Medical identifiers for Shandel Douglas such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1649798455	NPI	-	NPPES
0587613	Medicaid	NJ

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	26NJ00747600 (New Jersey)	Primary
363LP2300X	Nurse Practitioner - Primary Care	26NJ00747600 (New Jersey)	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shandel Douglas allows following entities to bill medicare on her behalf.

Entity Name	Visiting Nurse Association Of Central Jersey Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1336195791 PECOS PAC ID: 0244323160 Enrollment ID: O20140401000269

Entity Name	Vps Medical Services, Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1265077739 PECOS PAC ID: 2961836069 Enrollment ID: O20191226000592

Entity Name	Freeway Psychiatry Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1831819531 PECOS PAC ID: 6901274844 Enrollment ID: O20221123002571

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shandel Douglas is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Shandel Douglas, APN 21 Edgewood Road, Summit, NJ 07901 Ph: (973) 395-1550	Shandel Douglas, APN 310 Central Avenue, Suite 102, East Orange, NJ 07018 Ph: (973) 395-1550

Reviews and Comments

Nurse Practitioner Nurses in East Orange, NJ

Miss Hana Michele Baron, NP, RN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 385 Tremont Ave, East Orange, NJ 07018 Phone: 973-676-1000
Mrs. Carla Francis, APN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 385 Tremont Ave, East Orange, NJ 07018 Phone: 973-676-1000
Miss Adaugo Oriji, PNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 132 Halsted St, East Orange, NJ 07018 Phone: 973-674-0036
Devang Patel, AGPCNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 60 Evergreen Pl, East Orange, NJ 07018 Phone: 973-395-1550
Sanjaykumar Shah, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 310 Central Avenue, Suite 102, East Orange, NJ 07018 Phone: 973-395-1550 Fax: 973-395-1556
Dr. Theresa Reed, DNP, APN, ENP,FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 385 Tremont Ave, East Orange, NJ 07018 Phone: 973-676-1000 Fax: 973-395-7135
Ms. Janet Ellen Coley-lima, APN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 385 Tremont Avenue, Hbpc, Mail Code 11e-3, East Orange, NJ 07018 Phone: 973-676-1000 Fax: 973-395-7042

Shandel Douglas, APN - Medicare Nurse Practitioner in East Orange, NJ