Corina M Ianculovici, APRN, AG-PCP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

26NJ00862000 Issued in NJ

Practice address

2640 Hwy 70, BLDG.5
Building #5, Suite 102B
Manasquan, NJ 08736-9552

Phone

(732) 292-0100

Fax

(732) 292-0900

NPI assigned

Apr 11, 2018

Last updated

Oct 3, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

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

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.

• Primary Care Providers, LLC

  • Community Health Clinic/Center
  • Manasquan, NJ
  • NPI 1871068726
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1053818559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 HWY 70, BLDG.5",
            "address_2": "BUILDING #5, SUITE 102B",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087369552",
            "telephone_number": "347-539-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 HWY 70, BLDG.5",
            "address_2": "BUILDING #5, SUITE 102B",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087369552",
            "telephone_number": "732-292-0100",
            "fax_number": "732-292-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANCULOVICI",
        "first_name": "CORINA",
        "middle_name": "M",
        "credential": "APRN, AG-PCP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00862000",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ00862000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael L Howard, M.D.
• Iane Howe
• Arielle Hughes, PA-C
• Meaghan Hughes, LAC
• Margaret Hyde
• Jacqueline Marie Iannacone, PMHNP-BC, CARN
• Ronald Joseph Iannacone, DO
• Immediate Care and Family Medical Center LLC
• Marzena Incolla
• Kenneth G Indahl, DPM

• Primary Care Nurse Practitioner in Manasquan, NJ
• Providers in Manasquan, NJ by specialty
• Primary Care Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.