Individual provider Active NPI

Nichole Larysz

  • Family Nurse Practitioner
  • Fair Lawn, NJ
National Provider Identifier
1063278992
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ15010800 Issued in NJ
Practice address
5-15 Hartley PL
Fair Lawn, NJ 07410-3023
Phone
(551) 795-6223
NPI assigned
Feb 27, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ15010800 NJ Primary

Addresses

Primary practice location

5-15 Hartley PL
Fair Lawn, NJ 07410-3023

Mailing address

5-15 Hartley PL
Fair Lawn, NJ 07410-3023

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
I20240917000820 NJ Practitioner - Nurse Practitioner 7517408610 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physician Partners of Englewood PCGroup PAC ID 1153572482, 94 clinicians

Practice addresses (Care Compare)

350 Engle St
Englewood, NJ 07631-1898
Phone (201) 731-3178

Hospital & facility affiliations

  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Partners of Englewood, PC CurrentSince Jan 1, 2025 Accepting new patients
Medical Associates of Englewood, PC CurrentSince Jul 8, 2024 Accepting new patients

Locations

350 Engle St
Ste 5516
Englewood, NJ 07631
Phone (201) 731-3178

350 Engle St
Fl 5
Englewood, NJ 07631
Phone (201) 568-5250

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1063278992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5-15 HARTLEY PL",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5-15 HARTLEY PL",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103023",
            "telephone_number": "551-795-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARYSZ",
        "first_name": "NICHOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ15010800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

Verify at the official NPI Registry.