Individual provider Active NPI

Annie Leela Durairaj Daniel

  • Adult Health Nurse Practitioner
  • Oceanside, NY
National Provider Identifier
1003152323
Registry record updated Dec 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F306279-1 Issued in NY
Practice address
3094 Perry Ave
Oceanside, NY 11572-4235
Phone
(516) 343-0564
NPI assigned
Dec 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F306279-1 NY Primary

Addresses

Primary practice location

3094 Perry Ave
Oceanside, NY 11572-4235

Mailing address

3094 Perry Ave
Oceanside, NY 11572-4235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211011002815 NJ Practitioner - Nurse Practitioner 6002214715 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

195 Little Albany St
New Brunswick, NJ 08901-1914
Phone (732) 235-2465

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.4 of 100Reported as group
Quality
70.64
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00063900NJMDAdult Health Nurse Practitioner
F306279-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Robert Wood Johnson Medical Associates CurrentSince Jul 16, 2022 Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Aug 23, 2021 Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Aug 23, 2021 Accepting new patients

Locations

195 Little Albany St
New Brunswick, NJ 08901
Phone (732) 235-2465

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

125 Paterson St
Ste 5100
New Brunswick, NJ 08901
Phone (732) 235-7060

125 Paterson St
Ste 6100
New Brunswick, NJ 08901
Phone (732) 235-6561

66 W Gilbert St
Ste 200
Tinton Falls, NJ 07701
Phone (732) 212-0051

Interoperability endpoints

  • Direct secure messaging: adaniel17836@epicdirect.rwjbh.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1003152323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3094 PERRY AVE",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115724235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3094 PERRY AVE",
            "city": "OCEANSIDE",
            "state": "NY",
            "postal_code": "115724235",
            "telephone_number": "516-343-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "ANNIE",
        "middle_name": "LEELA DURAIRAJ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-13",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F306279-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, NY

Sources for this page

Verify at the official NPI Registry.