Genevieve Basanaga, NP

Individual provider Active NPI Family Nurse Practitioner · North Plainfield, NJ

NPI 1114600152 · NPPES record last updated Aug 9, 2023

Key facts

NPI
1114600152
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
26NJ14891200 (NJ)
Practice address
43-45 Pearl Street
North Plainfield, NJ 07060
Phone
(908) 822-9700
NPI assigned
Aug 8, 2023
Sex
Female
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Faith Family Health Care Professional Corp. (3 clinicians)

Practice addresses (Care Compare)

43 -45 Pearl St
North Plainfield, NJ 07060-4886
Phone (908) 822-9700

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20231211001011 NJ Practitioner - Nurse Practitioner 1759730112 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ14891200NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Family Health Care Professional Corp. Current
since Oct 30, 2023
Accepting new patients
Family Medicine Group LLC Past
since Aug 13, 2023
Accepting new patients

Locations

43 Pearl St
North Plainfield, NJ 07060
Phone (908) 822-9700

5 Mountain Blvd
Ste 3
Warren, NJ 07059
Phone (908) 755-5335

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered Nurse 163WW0000X 26NJ14891200 NJ
Family Nurse Practitioner 363LF0000X 26NJ14891200 NJ Yes

Addresses

Primary practice location

43-45 Pearl Street
North Plainfield, NJ 07060

Mailing address

22 Ewing Dr
Piscataway, NJ 08854-6266
Phone (732) 910-7605

Other providers in North Plainfield, NJ

All providers in North Plainfield, NJ · Family Nurse Practitioner in New Jersey

Sources for this page

Verify at the official NPI Registry.