Michelle Itidiare

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00625200 Issued in NJ

Practice address

347 Mount Pleasant Ave
Suite 103
West Orange, NJ 07052-2744

Phone

(908) 420-1361

NPI assigned

Dec 15, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• NJ Memory and Behavioral Care

  • Geriatric Psychiatry Physician
  • Cedar Knolls, NJ
  • NPI 1538499181
  Medicare reassignment NPD
• Signify Health Medical Associates of New Jersey, LLC

  • General Practice Physician
  • Princeton, NJ
  • NPI 1174187728
  Medicare reassignment NPD
• Brookview Medical Associates, PLLC

  • General Practice Physician
  • Bohemia, NY
  • NPI 1871965855
  Medicare reassignment NPD
• Jeffrey Rapaport,MD,PA

  • Procedural Dermatology Physician
  • Englewood Cliffs, NJ
  • NPI 1184777427
  Medicare reassignment
• Schweiger Dermatology, PC

  • Dermatology Physician
  • Elmer, NJ
  • NPI 1104229392
  NPD (past)

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1194180349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 MOUNT PLEASANT AVE",
            "address_2": "SUITE 103",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 MOUNT PLEASANT AVE",
            "address_2": "SUITE 103",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522744",
            "telephone_number": "908-420-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITIDIARE",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-15",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00625200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ioe Vision Care LLC
• Nataliya Ioshpa, NP
• Farida Iqbal-Hussain, MD
• Ira M Sonet DMD, PA.
• Isaac Kramer, MD, P.C.
• Kristin Marie Iturbides, MS CCC-SLP
• Robert A Ivker, DO
• Corine Iwuala
• Joycelene Iwuala
• Jack Gold Surgical Appliances, Inc.

• Family Nurse Practitioner in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.