Individual provider Active NPI

Lillian Carr

  • Adult Health Nurse Practitioner
  • East Brunswick, NJ
National Provider Identifier
1154751600
Registry record updated Nov 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00472200 Issued in NJ
Practice address
63 W Prospect St
East Brunswick, NJ 08816-5705
Phone
(201) 347-1103
NPI assigned
Nov 20, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00472200 NJ Primary

Addresses

Primary practice location

63 W Prospect St
East Brunswick, NJ 08816-5705

Mailing address

62 Taylors Mills Rd
Manalapan, NJ 07726-3428
Phone (201) 374-1103

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
I20140123001938 NJ Practitioner - Nurse Practitioner 6204064017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
F Gabriel Limited Liability CoGroup PAC ID 0749294429, 2 clinicians

Practice addresses (Care Compare)

449 Ave C
Bayonne, NJ 07002-5105
Phone (201) 374-1103

87 Brunswick Woods Dr
East Brunswick, NJ 08816-5601
Phone (732) 651-7122

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
F Gabriel Limited Liability Co CurrentSince Nov 1, 2013 Accepting new patients

Locations

449 Avenue C
Bayonne, NJ 07002
Phone (201) 823-2334

87 Brunswick Woods Dr
East Brunswick, NJ 08816
Phone (732) 254-0081

63 W Prospect St
East Brunswick, NJ 08816
Phone (732) 651-7122

Organizations & group practices 1

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": "1384905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384905600000",
    "number": "1154751600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 TAYLORS MILLS RD",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077263428",
            "telephone_number": "201-374-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 W PROSPECT ST",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165705",
            "telephone_number": "201-347-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "LILLIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-20",
        "last_updated": "2013-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00472200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.