Shandel Douglas, APN - Medicare Nurse Practitioner in River Edge, NJ

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Shandel Douglas, APN is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in River Edge, New Jersey. She graduated from nursing school in 2016 and has 10 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Lifebulb Llc, Evergreen Medical Group Pc and her current practice location is 887 Kinderkamack Rd, River Edge, New Jersey. You can reach out to her office (for appointments etc.) via phone at (201) 464-0860.

Shandel Douglas is licensed to practice in New Jersey (license number 26NJ00747600) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1649798455.

Contact Information

Shandel Douglas, APN
887 Kinderkamack Rd,
River Edge, NJ 07661-2307
(201) 464-0860
Not Available

Map and Direction




Provider's Profile

Full NameShandel Douglas
GenderFemale
SpecialityNurse Practitioner
Experience10 Years
Location887 Kinderkamack Rd, River Edge, New Jersey
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Shandel Douglas graduated from nursing school in 2016
  NPI Data:
  • NPI Number: 1649798455
  • Provider Enumeration Date: 08/31/2017
  • Last Update Date: 12/31/2025
  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.
IdentifierTypeStateIssuer
1649798455NPI-NPPES
0587613MedicaidNJ

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health 26NJ00747600 (New Jersey)Primary
363LP2300XNurse Practitioner - Primary Care 26NJ00747600 (New Jersey)Secondary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Lifebulb Llc206288116295
Evergreen Medical Group Pc276992908212

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 NameVisiting Nurse Association Of Central Jersey Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1336195791
PECOS PAC ID: 0244323160
Enrollment ID: O20140401000269
Entity NameVps Medical Services, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1265077739
PECOS PAC ID: 2961836069
Enrollment ID: O20191226000592
Entity NameFreeway Psychiatry Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI 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 AddressPractice Location Address
Shandel Douglas, APN
887 Kinderkamack Rd,
River Edge, NJ 07661-2307

Ph: (201) 464-0860		Shandel Douglas, APN
887 Kinderkamack Rd,
River Edge, NJ 07661-2307

Ph: (201) 464-0860

Reviews and Comments


Nurse Practitioner Nurses in River Edge, NJ

Mireya Pazmino, APN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 887 Kinderkamack Rd Ste 2, River Edge, NJ 07661
Phone: 201-464-0860    Fax: 888-440-2752
Mrs. Tosal Saxena, FNP-BC
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 887 Kinderkamack Rd, River Edge, NJ 07661
Phone: 201-464-0860    
Theresa A Schulze, NURSE PRACTITIONER
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 63 Grand Ave, River Edge, NJ 07661
Phone: 201-487-2900    Fax: 201-487-1022
Caroline W Wiltshire, APN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 887 Kinderkamack Rd, River Edge, NJ 07661
Phone: 201-646-0860    
Mrs. Michelle Rivera Dejesus, APN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 887 Kinderkamack Rd Ste 2, River Edge, NJ 07661
Phone: 201-464-0860    Fax: 888-440-2752
Maria Nunzia Petruzzelli, WHNP-BC
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 130 Kinderkamack Rd Ste 300, River Edge, NJ 07661
Phone: 201-489-2727    Fax: 201-489-5040

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.