Individual provider Active NPI

Taylor Nicole Jarema

  • Physician Assistant
  • Old Bridge, NJ
National Provider Identifier
1174175053
Registry record updated Aug 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00535700 Issued in NJ
Practice address
3548 US Highway 9
Old Bridge, NJ 08857-2765
Phone
(732) 201-6596
NPI assigned
Jul 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00535700 NJ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3548 US Highway 9
Old Bridge, NJ 08857-2765

Mailing address

441 Kosciusko Ave
South Plainfield, NJ 07080-3962

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
I20200218000233 NJ Practitioner - Physician Assistant 8325475189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates of Central New Jersey PAGroup PAC ID 4688697394, 11 clinicians

Practice addresses (Care Compare)

250 S St
Freehold, NJ 07728-2635
Phone (732) 780-7870

28 Throckmorton LN
Suite 204
Old Bridge, NJ 08857-2558
Phone (732) 679-6300

3548 Route 9
Old Bridge, NJ 08857-2765
Phone (732) 679-6300

3548 Route 9 S
Suite 2
Old Bridge, NJ 08857-2765

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shonta D Collins Consulting Group LLC PastSince Feb 23, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: taylor@centralnj.emadirect.md

Organizations & group practices 2

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": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566086400000",
    "number": "1174175053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 KOSCIUSKO AVE",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070803962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3548 US HIGHWAY 9",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572765",
            "telephone_number": "732-201-6596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAREMA",
        "first_name": "TAYLOR",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2019-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00535700",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

Verify at the official NPI Registry.