Individual provider Active NPI

Shivaa Arjyal

  • Gerontology Nurse Practitioner
  • Freehold, NJ
National Provider Identifier
1104412709
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ01081100 Issued in NJ
Practice address
901 W Main St
Freehold, NJ 07728-2537
Phone
(732) 610-4637
NPI assigned
Dec 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ01081100 NJ Primary

Addresses

Primary practice location

901 W Main St
Freehold, NJ 07728-2537

Mailing address

901 W Main St
Freehold, NJ 07728-2537

Organizations & group practices 3

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 4

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

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospitalist Physicians of New Jersey PA 162 clinicians

Practice addresses (Care Compare)

1 Riverview PLZ
Red Bank, NJ 07701-1864
Phone (732) 741-2700

Hospital & facility affiliations

  • Raritan Bay Medical Center Hospital, Perth Amboy, NJ, CCN 310039
  • JFK University Medical Center Hospital, Edison, NJ, CCN 310108

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
I20210209000642 NJ Practitioner - Nurse Practitioner 7911312749 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01081100NJMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holmdel Physician Associates CurrentSince Jan 4, 2021 Accepting new patients
NJ Acute Care Specialists Professional Corporation CurrentSince Jan 3, 2022 Accepting new patients
Hospitalist Physicians of New Jersey PA CurrentSince Jan 15, 2023 Accepting new patients

Locations

300 Central Ave
East Orange, NJ 07018
Phone (973) 266-8460

65 James St
Edison, NJ 08820
Phone (732) 321-7010

901 W Main St
Freehold, NJ 07728
Phone (732) 294-2666

727 N Beers St
Holmdel, NJ 07733
Phone (732) 714-2700

97 W Parkway
Pompton Plns, NJ 07444
Phone (973) 831-5000

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

1140 Route 72 W
Stafford Township, NJ 08050
Phone (609) 978-2194

66 W Gilbert St
Ste 200
Tinton Falls, NJ 07701
Phone (732) 212-0051

66 W Gilbert St
Tinton Falls, NJ 07701
Phone (732) 212-0051

Interoperability endpoints

  • Direct secure messaging: sarjyal424962@direct.ahsys.org

NPI Registry JSON

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1104412709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537",
            "telephone_number": "732-610-4637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARJYAL",
        "first_name": "SHIVAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ01081100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.