Mark Gerard Havlicek, A.P.N.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ01014700 Issued in NJ

Practice address

43 Yawpo Ave
Oakland, NJ 07436-2714

Phone

(201) 337-0066

NPI assigned

Jan 14, 2021

Sex

Male

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jersey Irish Medical 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Jersey Irish Medical

  • Urgent Care Clinic/Center
  • Bound Brook, NJ
  • NPI 1144575739

  NJ

  Medicare reassignment Care Compare group NPD
• Immediate Care Medical Walk-in of Hazlet, PA

  • Urgent Care Clinic/Center
  • Hazlet, NJ
  • NPI 1245595313

  NJ

  Medicare reassignment NPD
• Prohealth Urgent Care Medicine of New Jersey LLP

  • Emergency Care Clinic/Center
  • Edgewater, NJ
  • NPI 1477927754

  NJ

  Medicare reassignment NPD
• Urgent Care Physicians of New Jersey, LLC

  • Emergency Medicine Physician
  • Red Bank, NJ
  • NPI 1447622402

  NJ

  Medicare reassignment NPD

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1033708052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 SKYTOP RDG",
            "city": "OAKLAND",
            "state": "NJ",
            "postal_code": "074362355",
            "telephone_number": "201-663-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 YAWPO AVE",
            "city": "OAKLAND",
            "state": "NJ",
            "postal_code": "074362714",
            "telephone_number": "201-337-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVLICEK",
        "first_name": "MARK",
        "middle_name": "GERARD",
        "name_prefix": "Mr.",
        "credential": "A.P.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01014700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Austin Hajjar, M.D.
• Kristie Marie Hanlon, DC
• Olivia Hartos
• Darren G Hartung, DC
• Gary George Hartung, D.C.
• Heritage Laparoscopy Acute Care Surgery PC
• Heritage Surgical Group, LLC
• Heritage Surgical Partners, LLC
• Miosoty Hernandez, LMT
• James A Hertel, RPH

• All providers in Oakland, NJ
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.