KEMISOLA LYNDA EBIETOMIYE – Psychiatric/Mental Health Nurse Practitioner, NPI 1255102976
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,515 NURSE PRACTITIONER in NJ
Provider Addresses for KEMISOLA LYNDA EBIETOMIYE
2 University Plz Ste 100
Hackensack, NJ 076016210
Phone: (212) 203-1773
Fax: (646) 665-4427
Type: Location
801 7th Ave
Fort Worth, TX 761042733
Phone: (773) 621-8983
Fax: (469) 242-9827
Type: Location
548 WESTWOOD WAY DR
HASLET, TX 760523079
Phone: (469) 250-1544
Fax: (469) 242-9827
Type: Mailing
274 MADISON AVE RM 1501
NEW YORK, NY 100160701
Phone: (212) 203-1773
Fax: (646) 665-4427
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $113.
Total Amount is formed as General ($113) + Research ($0) + Ownership ($0) = $113.
Last reported payment date: 2024-02-16 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($113).
Total Amount
$113
General + Research + Ownership
Payments
1
Total payment records
General Amount
$113
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $113 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2026-02-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 7 Medicare enrollment records; no due dates published yet.
Enrollment records
7
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240229002809 | I | Nurse Practitioner | NY | TBD |
| I20240530001793 | I | Nurse Practitioner | NJ | TBD |
| I20241001004354 | I | Nurse Practitioner | TX | TBD |
| I20250815002723 | I | Nurse Practitioner | WA | TBD |
| I20250916000818 | I | Nurse Practitioner | IL | TBD |
| I20260106001092 | I | Nurse Practitioner | AZ | TBD |
| I20260225003253 | I | Nurse Practitioner | NM | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 07601)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | NY | |
| Clinical Social Worker | NY | |
| Clinical Social Worker | NY | |
| Mental Health Counselor | IL | |
| Nurse Practitioner | NY | |
| Nurse Practitioner | NY | |
| Nurse Practitioner | NJ | |
| Nurse Practitioner | NY | |
| Nurse Practitioner | NY | |
| Nurse Practitioner | PA |
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