Individual provider Active NPI

Virginia Azzariti, CPNP

  • Pediatric Nurse Practitioner
  • Teaneck, NJ
National Provider Identifier
1023109485
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
26NN03577100 Issued in NJ
Practice address
870 Palisade Avenue
Suite 201
Teaneck, NJ 07666
Phone
(201) 692-1661
Fax
(201) 692-9219
NPI assigned
Sep 28, 2006
Last updated
Jan 18, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 26NN03577100 NJ Primary

Addresses

Primary practice location

870 Palisade Avenue
Suite 201
Teaneck, NJ 07666

Mailing address

870 Palisade Avenue
Suite 201
Teaneck, NJ 07666
Phone (201) 692-1661

Other identifiers 1

IdentifierTypeStateIssuer
7922400MedicaidNJ

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
I20190409000034 NJ Practitioner - Nurse Practitioner 5395086961 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NN03577100NJMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care of New Jersey PC CurrentSince Jan 21, 2019 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Jan 21, 2019 Accepting new patients
Advocare, LLC CurrentSince Jan 11, 2026 Accepting new patients
Advocare , LLC CurrentSince Jan 11, 2026 Accepting new patients
A.G. Dikengil, MD, PA Past Accepting new patients
Advocare, LLC Past Accepting new patients

Locations

169 Mine Brook Rd
#P
Bernardsville, NJ 07924
Phone (908) 766-0034

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

38 Meadowlands Pkwy
Ste 205
Secaucus, NJ 07094
Phone (201) 552-2357

3403 S Delsea Dr
Vineland, NJ 08360
Phone (856) 293-6974

Interoperability endpoints

  • Direct secure messaging: vazzariti76852@direct.optum.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1023109485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 PALISADE AVENUE",
            "address_2": "SUITE 201",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "07666",
            "telephone_number": "201-692-1661",
            "fax_number": "201-692-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 PALISADE AVENUE",
            "address_2": "SUITE 201",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "07666",
            "telephone_number": "201-692-1661",
            "fax_number": "201-692-9219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZZARITI",
        "first_name": "VIRGINIA",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NN03577100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7922400",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.