Individual provider Active NPI

Lindsay Elizabeth Kellogg, APN

  • Nurse Practitioner
  • Randolph, NJ
National Provider Identifier
1003362195
Registry record updated Mar 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00664000 Issued in NJ
Practice address
765 Route 10 E
Suite 201
Randolph, NJ 07869-1925
Phone
(973) 989-0068
NPI assigned
Aug 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00664000 NJ
Nurse Practitioner 363L00000X 26NJ00664000 NJ Primary

Addresses

Primary practice location

765 Route 10 E
Suite 201
Randolph, NJ 07869-1925

Mailing address

105 Raider Blvd
Suite 101
Hillsborough, NJ 08844-1528
Phone (908) 281-0221

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
I20161010000143 NJ Practitioner - Nurse Practitioner 7911295803 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

333 Mount Hope Ave
Rockaway, NJ 07866-1645
Phone (973) 895-6600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Id Care LLC CurrentSince Nov 1, 2016 Accepting new patients
Practice Associates Medical Group CurrentSince Oct 29, 2021 Accepting new patients

Locations

105 Raider Blvd
Ste 101
Hillsborough, NJ 08844
Phone (908) 281-0221

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

765 Route 10 E
Ste 201
Randolph, NJ 07869
Phone (973) 479-1128

333 Mount Hope Ave
Ste 230
Rockaway, NJ 07866
Phone (973) 379-2111

333 Mount Hope Ave
Rockaway, NJ 07866
Phone (973) 895-6601

385 Morris Ave
Ste 2
Springfield, NJ 07081

Organizations & group practices 2

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 2

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": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490918400000",
    "number": "1003362195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 RAIDER BLVD",
            "address_2": "SUITE 101",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088441528",
            "telephone_number": "908-281-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 ROUTE 10 E",
            "address_2": "SUITE 201",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078691925",
            "telephone_number": "973-989-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLOGG",
        "first_name": "LINDSAY",
        "middle_name": "ELIZABETH",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-29",
        "last_updated": "2017-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00664000",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00664000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, NJ

Sources for this page

Verify at the official NPI Registry.