Paulina Mmereole, APN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

26NJ00504700 Issued in NJ

Practice address

6101 Kennedy Blvd E
Ste 1
West New York, NJ 07093-3902

Phone

(201) 448-2804

NPI assigned

Jun 23, 2014

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

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: paulina.mmereole.1@15956.direct.athenahealth.com

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.

• Barnabas Health Medical Group PC

  • Specialist
  • Elizabeth, NJ
  • NPI 1841557246
  Medicare reassignment
• Rwjbh Primary Care Services

  • Internal Medicine Physician
  • West Orange, NJ
  • NPI 1265037501
  Medicare reassignment

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493683200000",
    "number": "1083029656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 KENNEDY BLVD E",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070933902",
            "telephone_number": "201-448-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 KENNEDY BLVD E",
            "address_2": "STE 1",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070933902",
            "telephone_number": "201-448-2804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MMEREOLE",
        "first_name": "PAULINA",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2017-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NJ00504700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0420964",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miller Dental Arts, P.a.
• Bradley S Miller, D.M.D
• Omar Hasan Miqbel
• Dinesh R Mirpuri, OTR/L
• Stephanie Mitchell, LMT
• Robert U Mmereole, MD
• Monica Barrientos MD LLC
• Dwight Randolph Montfort, RPH.
• Cynthia Montilla, LMT
• Harris Ira Moore, D.C.

• Pediatric Nurse Practitioner in West New York, NJ
• Providers in West New York, NJ by specialty
• Pediatric Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.