Individual provider Active NPI

Patience Assobmo, NP

  • Women's Health Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1124595723
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
26NJ00867100 Issued in NJ
Practice address
15 Shaw Avenue
Newark, NJ 07112
Phone
(347) 824-8984
NPI assigned
Nov 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 26NJ00867100 NJ Primary

Addresses

Primary practice location

15 Shaw Avenue
Newark, NJ 07112

Mailing address

15 Shaw Avenue
Newark, NJ 07112
Phone (347) 824-8984

Other names 1

  • Patience Marks Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20201125002039 MA Practitioner - Nurse Practitioner 7810308723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

3300 Main St
FL 4
Springfield, MA 01107-1112
Phone (413) 794-7045

Hospital & facility affiliations

  • Baystate Medical Center Hospital, Springfield, MA, CCN 220077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00867100NJMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Health Associates of Western Ma Inc. CurrentSince Nov 20, 2020 Accepting new patients
Baystate Medical Practices, Inc CurrentSince Sep 30, 2024 Accepting new patients
Baystate Medical Center, Inc. PastSince Sep 30, 2024 Accepting new patients

Locations

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

3300 Main St
Fl 4
Springfield, MA 01107
Phone (413) 794-5555

280 Chestnut St
Springfield, MA 01199
Phone (413) 794-3909

65 Springfield Rd
Ste 2
Westfield, MA 01085
Phone (413) 562-8306

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1124595723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SHAW AVENUE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07112",
            "telephone_number": "347-824-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SHAW AVENUE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07112",
            "telephone_number": "347-824-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASSOBMO",
        "first_name": "PATIENCE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-01",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NJ",
            "license": "26NJ00867100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATIENCE",
            "last_name": "MARKS",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.