SHANDEL DOUGLAS (APN) – Psychiatric/Mental Health Nurse Practitioner, NPI 1649798455
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,515 NURSE PRACTITIONER in NJ
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Provider Addresses for SHANDEL DOUGLAS (APN)
887 KINDERKAMACK RD
RIVER EDGE, NJ 076612307
Phone: (201) 464-0860
Type: Mailing
21, Edgewood Road, Overlook, Summit, Union County, New Jersey, 07901, United States
SUMMIT, NJ 07901
Phone: (973) 395-1550
Fax: (973) 395-1556
Type: Mailing
310, Central Avenue, City of Orange, Orange, Essex County, New Jersey, 07050, United States
SUITE 102
EAST ORANGE, NJ 07018
Phone: (973) 395-1550
Fax: (973) 395-1556
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 14 Open Payments records for all available years, with a total value of $248.
Total Amount is formed as General ($248) + Research ($0) + Ownership ($0) = $248.
Last reported payment date: 2024-11-13 • Largest payer in this snapshot: ABBVIE INC. ($101).
Total Amount
$248
General + Research + Ownership
Payments
14
Total payment records
General Amount
$248
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-13
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2017-11-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20171113003306 | I | Nurse Practitioner | NJ | 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 07661)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | NJ | |
| Mental Health Counselor | VA | |
| Clinical Social Worker | NJ | |
| Clinical Social Worker | NJ | |
| Mental Health Counselor | VA | |
| Clinical Social Worker | NJ | |
| Mental Health Counselor | VA | |
| Clinical Social Worker | VA | |
| Mental Health Counselor | NJ | |
| Clinical Social Worker | NY |
Reviews
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