Individual provider Active NPI

Michelle Iannello, FNP-BC

  • Family Nurse Practitioner
  • Shrewsbury, NJ
National Provider Identifier
1013683994
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ01178000 Issued in NJ
Practice address
655 Shrewsbury Ave
Shrewsbury, NJ 07702-4179
Phone
(732) 263-7903
NPI assigned
Aug 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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 26NJ01178000 NJ Primary

Addresses

Primary practice location

655 Shrewsbury Ave
Shrewsbury, NJ 07702-4179

Mailing address

9 Stonehurst Ter
Hazlet, NJ 07730-1826
Phone (732) 687-8111

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
I20220901002059 NJ Practitioner - Nurse Practitioner 4082098595 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

30 Prospect Ave
Hackensack, NJ 07601-1915

655 Shrewsbury Ave
Suite 201
Shrewsbury, NJ 07702-4151
Phone (732) 263-7903

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01178000NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose Throat of New Jersey, P.a. CurrentSince Aug 16, 2022 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jun 24, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jun 24, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients
Atlantic ENT Group LLC PastSince Aug 1, 2021 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

655 Shrewsbury Ave
Ste 201
Shrewsbury, NJ 07702
Phone (732) 263-7903

500 Lakehurst Rd
Toms River, NJ 08755
Phone (732) 914-2233

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1013683994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 STONEHURST TER",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301826",
            "telephone_number": "732-687-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 SHREWSBURY AVE",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024179",
            "telephone_number": "732-263-7903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNELLO",
        "first_name": "MICHELLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-19",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ01178000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shrewsbury, NJ

Sources for this page

Verify at the official NPI Registry.