Individual provider Active NPI

Carolina Arencibia, NP-C

  • Adult Health Nurse Practitioner
  • Dover, NJ
National Provider Identifier
1164056107
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ01031300 Issued in NJ
Practice address
18 W Blackwell St
Dover, NJ 07801-3841
Phone
(973) 328-3344
NPI assigned
Feb 28, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR15544600 NJ
Adult Health Nurse Practitioner 363LA2200X 26NJ01031300 NJ Primary

Addresses

Primary practice location

18 W Blackwell St
Dover, NJ 07801-3841

Mailing address

18 W Blackwell St
Dover, NJ 07801-3841
Phone (973) 328-3344

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
I20210907000159 NJ Practitioner - Nurse Practitioner 1153727896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Zufall Health Center, Inc 45 clinicians

Practice addresses (Care Compare)

18 W Blackwell St
Dover, NJ 07801-3841
Phone (973) 328-9100

4 Atno Ave
Morristown, NJ 07960-3802
Phone (973) 267-0002

Hospital & facility affiliations

  • Saint Clare'S Hospital/ Denville Campus Hospital, Denville, NJ, CCN 310050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR15544600NJMDRegistered Nurse
26NJ01031300NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Zufall Health Center, Inc CurrentSince Apr 25, 2024 Accepting new patients
Zufall Health Center, Inc CurrentSince Apr 25, 2024 Accepting new patients
Zufall Health Center,Inc Past Accepting new patients

Locations

17 S Warren St
#0
Dover, NJ 07801

18 W Blackwell St
Dover, NJ 07801
Phone (973) 328-3344

95 Northfield Ave
West Orange, NJ 07052
Phone (973) 325-2266

Organizations & group practices 11

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 1

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": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1164056107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 W BLACKWELL ST",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078013841",
            "telephone_number": "973-328-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 W BLACKWELL ST",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078013841",
            "telephone_number": "973-328-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARENCIBIA",
        "first_name": "CAROLINA",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-28",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR15544600",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ01031300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NJ

Sources for this page

Verify at the official NPI Registry.