Individual provider Active NPI

Chelsea Marie Covino, PA-C

  • Family Medicine Physician
  • Bloomfield, NJ
National Provider Identifier
1104661578
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MP00859500 Issued in NJ
Practice address
322 Glenwood Ave
Bloomfield, NJ 07003
Phone
(973) 929-7600
NPI assigned
Jun 27, 2024
Last updated
Jul 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MP00859500 NJ
Family Medicine Physician 207Q00000X 25MP00859500 NJ Primary

Addresses

Primary practice location

322 Glenwood Ave
Bloomfield, NJ 07003

Mailing address

17 Red Coach LN
Holmdel, NJ 07733-1138
Phone (732) 395-0234

Other practice location 1

200 Freeway Dr E Ste 305
East Orange, NJ 07018-3837
Phone (973) 310-2000

Other practice location 2

462 1st Ave
New York, NY 10016-9196
Phone (212) 562-4141

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
I20240912000886 NJ Practitioner - Physician Assistant 0042750119 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00859500NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crescent Medical Group PC Family Medicine Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: ccovino3790631@nychhc.direct-ci.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1104661578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 RED COACH LN",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331138",
            "telephone_number": "732-395-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 GLENWOOD AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "07003",
            "telephone_number": "973-929-7600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Freeway Dr E Ste 305",
            "address_purpose": "LOCATION",
            "city": "East Orange",
            "state": "NJ",
            "postal_code": "070183837",
            "country_code": "US",
            "telephone_number": "973-310-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "462 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100169196",
            "country_code": "US",
            "telephone_number": "212-562-4141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COVINO",
        "first_name": "CHELSEA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MP00859500",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MP00859500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, NJ

Sources for this page

Verify at the official NPI Registry.