NPIMap

Organization Active NPI

Windsor Advanced Practice Nursing PC

  • Adult Health Nurse Practitioner
  • Norwood, NJ
National Provider Identifier
1033595897
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
WINDSOR ADVANCED PRACTICE NURSING PC
Practice address
100 McClellen St
Norwood, NJ 07648-1555
Phone
(201) 767-0100
NPI assigned
Aug 4, 2015
Last updated
Aug 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Authorized official

Name
Miss Teresa Deperalta, MSN, APN-BC
Title
Nuese Practitionor
Phone
(201) 767-0100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X Primary

Addresses

Primary practice location

100 McClellen St
Norwood, NJ 07648-1555

Mailing address

100 McClellen St
Norwood, NJ 07648-1555

Other identifiers 1

IdentifierTypeStateIssuer
1OtherNJAPPLIED FOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151118000192 NJ Part B Supplier - Clinic/Group Practice 9032419320 Receives reassigned benefits from 11 practitioners
Practice locations: South Amboy, NJ

National Provider Directory

National Provider Directory

Locations

275 John T Oleary Blvd
Venetian Care and Re
South Amboy, NJ 08879
Phone (732) 721-8200

275 John T Oleary Blvd
Venetian Care and Rehabilitation Ctr
South Amboy, NJ 08879
Phone (732) 721-8200

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1033595897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MCCLELLEN ST",
            "city": "NORWOOD",
            "state": "NJ",
            "postal_code": "076481555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MCCLELLEN ST",
            "city": "NORWOOD",
            "state": "NJ",
            "postal_code": "076481555",
            "telephone_number": "201-767-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDSOR ADVANCED PRACTICE NURSING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-04",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "DEPERALTA",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "NUESE PRACTITIONOR",
        "authorized_official_telephone_number": "201-767-0100",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MSN, APN-BC"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APPLIED FOR",
            "identifier": "1",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.