Individual provider Active NPI

Kelly St. Marie, MSN, FNP-C

  • Family Nurse Practitioner
  • Toms River, NJ
National Provider Identifier
1013626936
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01399700 Issued in NJ
Practice address
2360 Lakewood Rd
Toms River, NJ 08755-1929
Phone
(732) 719-7788
NPI assigned
Nov 18, 2022
Last updated
Nov 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ01399700 NJ Primary

Addresses

Primary practice location

2360 Lakewood Rd
Toms River, NJ 08755-1929

Mailing address

44 Union Ave Apt D
Neptune, NJ 07753-6376

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
I20221228002243 NJ Practitioner - Nurse Practitioner 3173993631 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Physicians of New Jersey LLCGroup PAC ID 1658674585, 96 clinicians

Practice addresses (Care Compare)

46 Newman Springs Rd E
Suite F
Red Bank, NJ 07701-1531
Phone (732) 933-4100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ01399700NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Golding Granado Medical Associates PastSince Apr 23, 2024 Accepting new patients

Organizations & group practices 3

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

Hospital & facility affiliations 1

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": "1668729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1013626936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 UNION AVE APT D",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077536376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 LAKEWOOD RD",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087551929",
            "telephone_number": "732-719-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. MARIE",
        "first_name": "KELLY",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-18",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01399700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

Verify at the official NPI Registry.