Jacquelyn Marie Amodeo, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ01091800 Issued in NJ

Practice address

246 Hamburg Tpke Ste 205
Wayne, NJ 07470-2160

Phone

(973) 389-1800

NPI assigned

Dec 15, 2020

Last updated

Dec 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Josephs Physicians Healthcare Group IncGroup PAC ID 2567645401, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

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

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.

• St. Josephs Physicians Healthcare Group Inc

  • Cardiovascular Disease Physician
  • Paterson, NJ
  • NPI 1033410907
  Medicare reassignment Care Compare group NPD
• High Mountain Health, PA

  • Family Medicine Physician
  • Wayne, NJ
  • NPI 1154376275
  Medicare reassignment NPD
• St. Joseph's Healthcare, Inc.

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1497791297
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Josephs University Medical Center Inc.

  • General Acute Care Hospital
  • Paterson, NJ
  • NPI 1669462420
  Care Compare affiliation

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1033705033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 HAMBURG TPKE STE 205",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702160",
            "telephone_number": "973-389-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 HAMBURG TPKE STE 205",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702160",
            "telephone_number": "973-389-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMODEO",
        "first_name": "JACQUELYN",
        "middle_name": "MARIE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-15",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01091800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Ambrose, M.D.
• Maria G Ambrosio, D.M.D
• Ambulatory Anesthesia Services, P.a.
• Georgiette Ameyaw-Wordie, FNP
• James Amir, DMD
• Robert Charles Amoruso, MD
• Catherine Andrasko, DPT
• Peter Andrawis, PHARMD
• Andrew Howard Speech Therapy
• Steven Andriulli, MA

• Nurse Practitioner in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.