Individual provider Active NPI

Jeanne A Craft, M.D.

  • Pediatric Critical Care Medicine Physician
  • Livingston, NJ
National Provider Identifier
1124093612
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
25MA06250800 Issued in NJ
Practice address
94 Old Short Hills Rd
Pediatric Intensive Care Unit
Livingston, NJ 07039-5672
Phone
(973) 322-2322
Fax
(973) 322-5504
NPI assigned
Feb 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Informatics Physician 2083C0008X 25MA06250800 NJ
Pediatric Critical Care Medicine Physician 2080P0203X 25MA06250800 NJ Primary
Pediatrics Physician 208000000X 25MA06250800 NJ

Addresses

Primary practice location

94 Old Short Hills Rd
Pediatric Intensive Care Unit
Livingston, NJ 07039-5672

Mailing address

17 Melbourne Way
Basking Ridge, NJ 07920-2507
Phone (908) 221-1310

Other identifiers 1

IdentifierTypeStateIssuer
6606601MedicaidNJ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070525000323 NJ Practitioner - Pediatric Medicine 8224135264 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA06250800NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Oct 28, 2023 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Oct 28, 2023 Accepting new patients
Specialty Care of Practice Associates,PA Pediatric Critical Care Medicine Past Accepting new patients
Practice Associates,Inc Pediatrics Past Accepting new patients

Locations

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

Interoperability endpoints

  • Direct secure messaging: jcraft17317@epicdirect.rwjbh.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1124093612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 MELBOURNE WAY",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079202507",
            "telephone_number": "908-221-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 OLD SHORT HILLS RD",
            "address_2": "PEDIATRIC INTENSIVE CARE UNIT",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395672",
            "telephone_number": "973-322-2322",
            "fax_number": "973-322-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAFT",
        "first_name": "JEANNE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-20",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083C0008X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Clinical Informatics",
            "state": "NJ",
            "license": "25MA06250800",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NJ",
            "license": "25MA06250800",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06250800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6606601",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.