Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Elyse Fearon

Individual provider Primary Care Nurse Practitioner · NPI 1720896491

Elyse Fearon is a Nurse Practitioner in Bloomfield, New Jersey. Qualified in 2024, 2 years ago. Practices with John V Kelly MD PC, a 5-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
2
Licensed in
NJ
In the registry since
2024
Specialties on file
2

Practice location Address checks out

382 W Passaic Ave
Bloomfield, NJ 07003-5554
Phone: (973) 338-1900
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 26NJ15226200 (NJ)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence 26NJ15226200 (NJ)

Record details

NPI number1720896491
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 26, 2024
Last updated in NPPESDecember 26, 2024
Certification dateDecember 26, 2024
Mailing address87 Union St, Cedar Grove, NJ 07009-1925

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice John V Kelly Md Pc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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