Individual provider Active NPI

Aniamma Thomas Vengath, AGACNP

  • Acute Care Nurse Practitioner
  • East Brunswick, NJ
National Provider Identifier
1033685300
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NJ00864000 Issued in NJ
Practice address
10 Jernee Dr
East Brunswick, NJ 08816-5307
Phone
(732) 485-7776
NPI assigned
Oct 15, 2018
Last updated
Aug 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 26NJ00864000 NJ Primary

Addresses

Primary practice location

10 Jernee Dr
East Brunswick, NJ 08816-5307

Mailing address

10 Jernee Dr
East Brunswick, NJ 08816-5307
Phone (732) 485-7776

Other practice location 1

110 Rehill Ave
Somerville, NJ 08876-2519
Phone (908) 685-2200

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
I20240831000354 NJ Practitioner - Nurse Practitioner 5799108460 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Primary Care Services CurrentSince Aug 1, 2024 Accepting new patients
Robert Wood Johnson Medical Associates CurrentSince Aug 1, 2024 Accepting new patients

Locations

25 Kilmer Dr
Ste 107
Morganville, NJ 07751
Phone (732) 385-5262

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

8 Mountain Blvd
Ste J
Warren, NJ 07059
Phone (732) 893-0200

Organizations & group practices 2

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": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1033685300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 JERNEE DR",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165307",
            "telephone_number": "732-485-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 JERNEE DR",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165307",
            "telephone_number": "732-485-7776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Rehill Ave",
            "address_purpose": "LOCATION",
            "city": "Somerville",
            "state": "NJ",
            "postal_code": "088762519",
            "country_code": "US",
            "telephone_number": "908-685-2200",
            "fax_number": "732-923-2272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENGATH",
        "first_name": "ANIAMMA",
        "middle_name": "THOMAS",
        "name_prefix": "Mrs.",
        "credential": "AGACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ00864000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.