Individual provider Active NPI

Corinne Desevo, APN

  • Adult Health Nurse Practitioner
  • Tinton Falls, NJ
National Provider Identifier
1023553468
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00674500 Issued in NJ
Practice address
656 Shrewsbury Ave
#300
Tinton Falls, NJ 07701-4964
Phone
(732) 531-5200
Fax
(732) 531-5836
NPI assigned
Dec 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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 26NJ00674500 NJ Primary

Addresses

Primary practice location

656 Shrewsbury Ave
#300
Tinton Falls, NJ 07701-4964

Mailing address

656 Shrewsbury Ave
#300
Tinton Falls, NJ 07701-4964
Phone (732) 531-5200

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
I20170303000055 NJ Practitioner - Nurse Practitioner 7416231816 Reassigns benefits to 1 organization

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 addresses (Care Compare)

175 Madison Ave
Mount Holly, NJ 08060-2038
Phone (844) 346-7222

180 White Rd
Little Silver, NJ 07739-1166
Phone (609) 835-2900

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (844) 346-7222

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Cancer Care Associates LLC CurrentSince Nov 1, 2019 Accepting new patients
Regional Cancer Care Associates LLC CurrentSince Nov 1, 2019 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC PastSince Jan 4, 2017 Accepting new patients

Locations

25 Main St
Ste 601
Hackensack, NJ 07601
Phone (201) 510-0910

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

180 White Rd
Ste 101
Little Silver, NJ 07739
Phone (732) 530-8666

175 Madison Ave
Mount Holly, NJ 08060
Phone (609) 261-1660

Interoperability endpoints

  • Direct secure messaging: corinne.desevo@direct.hackensackmeridian.org

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 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": "1482192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1023553468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "656 SHREWSBURY AVE",
            "address_2": "#300",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014964",
            "telephone_number": "732-531-5200",
            "fax_number": "732-531-5836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 SHREWSBURY AVE",
            "address_2": "#300",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014964",
            "telephone_number": "732-531-5200",
            "fax_number": "732-531-5836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESEVO",
        "first_name": "CORINNE",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-20",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00674500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinton Falls, NJ

Sources for this page

Verify at the official NPI Registry.