Alix Detullio, APN

Primary specialty

Acute Care Clinical Nurse SpecialistTaxonomy code 364SA2100X

License

26NJ00532200 Issued in NJ

Practice address

901 W Main St
Freehold, NJ 07728-2537

Phone

(732) 431-0023

NPI assigned

Dec 11, 2014

Last updated

Dec 11, 2014By 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

Merit-based Incentive Payment System (MIPS)

Final score

81.06 of 100Reported as group

Quality

62.57

Improvement activities

40

Cost

70.1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Freehold Hospitalists, LLC

  • Hospitalist Physician
  • Freehold, NJ
  • NPI 1831231463
  Medicare reassignment NPD

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1043618747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 ROUTE 9 N",
            "address_2": "SUITE B",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077288305",
            "telephone_number": "732-431-0023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537",
            "telephone_number": "732-431-0023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETULLIO",
        "first_name": "ALIX",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "NJ",
            "license": "26NJ00532200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dermone Dermatology Associates of the Garden State, PC
• Rajen Uday Desai, M.D.
• Alexandria Noelle Desalvatore, OTR
• Eugene L Desalvo, MD
• Poornima Deshmukh, M.D.
• John P Detullio, M.D., F.C.C.P.
• Development 4 Individuals With Disability
• Devereux NJ Reach Treatment Home
• Rachel Devincenzo
• Suzanne C Devoti, LCSW

• Acute Care Clinical Nurse Specialist in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Acute Care Clinical Nurse Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.