Individual provider Active NPI

Yilenny Dejesus Duran

  • Family Nurse Practitioner
  • Paterson, NJ
National Provider Identifier
1154892941
Registry record updated Dec 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00872300 Issued in NJ
Practice address
936 E 23Rd St
Paterson, NJ 07513-1518
Phone
(973) 968-0511
NPI assigned
Dec 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00872300 NJ Primary

Addresses

Primary practice location

936 E 23Rd St
Paterson, NJ 07513-1518

Mailing address

936 E 23Rd St
Paterson, NJ 07513-1518

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
I20200507000297 NJ Practitioner - Nurse Practitioner 9830520840 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
Optum Medical Care of New Jersey PCGroup PAC ID 3072650290, 168 clinicians

Practice addresses (Care Compare)

714 10TH St
Secaucus, NJ 07094-2921
Phone 20186333460000

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
71.59
Promoting interoperability
100
Improvement activities
40
Cost
76.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00872300NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care of New Jersey PC CurrentSince Mar 1, 2020 Accepting new patients
Signify Health Medical Associates of New Jersey, LLC CurrentSince Mar 1, 2025 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Mar 1, 2020 Accepting new patients
A.G. Dikengil, MD, PA Past Accepting new patients
Riverside Medical Group Past Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

1 Maywood Ave
Maywood, NJ 07607
Phone (201) 464-4772

116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 285-3094

714 10th St
Secaucus, NJ 07094
Phone (201) 863-3346

55 Morris Ave
Ste 100
Springfield, NJ 07081
Phone (908) 687-7250

3403 S Delsea Dr
Vineland, NJ 08360
Phone (856) 293-6974

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: ydejesusduran76856@direct.optum.com

Organizations & group practices 5

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": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544054400000",
    "number": "1154892941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 E 23RD ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075131518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 E 23RD ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075131518",
            "telephone_number": "973-968-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURAN",
        "first_name": "YILENNY",
        "middle_name": "DEJESUS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-06",
        "last_updated": "2018-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00872300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.