Amy Dericks Lober, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ00174700 Issued in NJ

Practice address

1945 Rte 33
Cardiac Surgery
Neptune, NJ 07753-4859

Phone

(732) 776-4622

NPI assigned

Nov 4, 2008

Sex

Female

Sole proprietor

No

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peak Wellness Center PCGroup PAC ID 6709385065, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Peak Wellness Center PC

  • Family Nurse Practitioner
  • Somerset, NJ
  • NPI 1982498515
  Medicare reassignment Care Compare group NPD
• Airport Plaza Spine & Wellness LLC

  • Interventional Pain Medicine Physician
  • Hazlet, NJ
  • NPI 1881053197
  Medicare reassignment NPD

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225756800000",
    "number": "1104070135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 STANFORD DR",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077302313",
            "telephone_number": "858-752-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 RTE 33",
            "address_2": "CARDIAC SURGERY",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534859",
            "telephone_number": "732-776-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOBER",
        "first_name": "AMY",
        "middle_name": "DERICKS",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2008-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00174700",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00174700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Liu
• Jian Liu, M.D.
• Living in Harmony LLC
• Denise L Livingston, MD, PHD
• Rolando Llull Tombo, MD
• Abdul Salam Din Lone, MD
• Monica Lopez-Islas, MD
• Melissa Lopez, MD
• Leighann Elizabeth Lorusso, BCBA
• Elizabeth Lotts, RDN

• Nurse Practitioner in Neptune, NJ
• Providers in Neptune, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; 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.