Organization Active NPI

Nursepractitionerco

  • Family Nurse Practitioner
  • Edison, NJ
National Provider Identifier
1124867098
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
NURSEPRACTITIONERCO
Practice address
21 Back Dr
Edison, NJ 08817-3020
Phone
(347) 528-2025
NPI assigned
May 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Authorized official

Name
Sarah Rosenstock, APNNPI 1437810587
Title
Owner
Phone
(347) 528-2025

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

21 Back Dr
Edison, NJ 08817-3020

Mailing address

21 Back Dr
Edison, NJ 08817-3020
Phone (347) 528-2025

Other names 1

  • WellnessExpress Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250423000066 NJ Part B Supplier - Clinic/Group Practice 0749705721 Receives reassigned benefits from 2 practitioners
Practice locations: Edison, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2304973Wellnessexpress21 Back Drive, Edison, NJ 08817Certificate of waiverMay 20, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1124867098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 BACK DR",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088173020",
            "telephone_number": "347-528-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 BACK DR",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088173020",
            "telephone_number": "347-528-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURSEPRACTITIONERCO",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "ROSENSTOCK",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-528-2025",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellnessExpress",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.