Individual provider Active NPI

Kimberly A Herlihy Rand, NP

  • Family Nurse Practitioner
  • Wall Township, NJ
National Provider Identifier
1093092488
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00344300 Issued in NJ
Practice address
3350 Highway 138 Ste 122
Wall Township, NJ 07719-9694
Phone
(732) 280-1200
Fax
(732) 280-1207
NPI assigned
Nov 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 26NJ00344300 NJ Primary

Addresses

Primary practice location

3350 Highway 138 Ste 122
Wall Township, NJ 07719-9694

Mailing address

3350 Highway 138 Ste 122
Wall Township, NJ 07719-9694
Phone (732) 280-1200

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
I20111228000733 NJ Practitioner - Nurse Practitioner 5991971707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cosulich Dermatology LLCGroup PAC ID 0446426019, 4 clinicians

Practice addresses (Care Compare)

3350 Hwy 138 W
BLDG 2 Suite 122
Wall, NJ 07719-9694
Phone (732) 280-1200

Merit-based Incentive Payment System (MIPS)

Final score
94.75 of 100Reported as individual
Quality
90.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00344300NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cosulich Dermatology 2 LLC CurrentSince Aug 10, 2026 Accepting new patients
Cosulich Dermatology LLC CurrentSince Aug 1, 2016 Accepting new patients

Locations

1004 Commons Way
Bldg G
Toms River, NJ 08755

1004 Commons Way
#G
Toms River, NJ 08755
Phone (732) 349-6868

3350 State Route 138
Ste 122
Wall Township, NJ 07719
Phone (732) 280-1200

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.

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1093092488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 HIGHWAY 138 STE 122",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077199694",
            "telephone_number": "732-280-1200",
            "fax_number": "732-280-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 HIGHWAY 138 STE 122",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077199694",
            "telephone_number": "732-280-1200",
            "fax_number": "732-280-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERLIHY RAND",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00344300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wall Township, NJ

Sources for this page

Verify at the official NPI Registry.