Individual provider Active NPI

Katherine Clemente, FNP-BC, MSN, RN, BSN

  • Family Nurse Practitioner
  • Holmdel, NJ
National Provider Identifier
1174932073
Registry record updated May 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00511200 Issued in NJ
Practice address
717 N Beers St
Suite 2D
Holmdel, NJ 07733-1524
Phone
(732) 203-9680
NPI assigned
Aug 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00511200 NJ Primary
Family Nurse Practitioner 363LF0000X F338992-1 NY

Addresses

Primary practice location

717 N Beers St
Suite 2D
Holmdel, NJ 07733-1524

Mailing address

717 N Beers St
Suite 2D
Holmdel, NJ 07733-1524
Phone (732) 203-9680

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
I20160518000087 NJ Practitioner - Nurse Practitioner 9638468408 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
F338992-1NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
V.K. Perkari M.D. LLC CurrentSince Mar 12, 2016 Accepting new patients

Locations

717 N Beers St
Ste 2D
Holmdel, NJ 07733
Phone (732) 203-9680

428 Lloyd Rd
Matawan, NJ 07747
Phone (732) 203-9680

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DADGCA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462924800000",
    "number": "1174932073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 N BEERS ST",
            "address_2": "SUITE 2D",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331524",
            "telephone_number": "732-203-9680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 N BEERS ST",
            "address_2": "SUITE 2D",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331524",
            "telephone_number": "732-203-9680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTE",
        "first_name": "KATHERINE",
        "credential": "FNP-BC, MSN, RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2016-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00511200",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338992-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

Verify at the official NPI Registry.