Individual provider Active NPI

Annamma George, NP

  • Nurse Practitioner
  • Waldwick, NJ
National Provider Identifier
1205220910
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00534600 Issued in NJ
Practice address
140 Franklin Tpke Ste 6a
Waldwick, NJ 07463-1836
Phone
(201) 447-3603
Fax
(201) 447-5184
NPI assigned
Mar 20, 2015
Last updated
Sep 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00534600 NJ Primary

Addresses

Primary practice location

140 Franklin Tpke Ste 6a
Waldwick, NJ 07463-1836

Mailing address

140 Franklin Tpke Ste 6a
Waldwick, NJ 07463-1836
Phone (201) 447-3603

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
I20211018000209 NJ Practitioner - Nurse Practitioner 4183022403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians

Practice addresses (Care Compare)

108 Jackson St
Apt 6B
Hoboken, NJ 07030-6101
Phone (800) 825-5391

223 N Van Dien Ave
Ridgewood, NJ 07450-2726
Phone (201) 447-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.05 of 100Reported as apm
Quality
85.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00534600NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physician Services PC CurrentSince Oct 1, 2021 Accepting new patients
Endocrinology and Diabetes Associates, LLC PastSince Mar 1, 2009 Accepting new patients

Locations

140 Franklin Tpke
Waldwick, NJ 07463
Phone (201) 447-3603

140 Franklin Tpke
Ste 6A
Waldwick, NJ 07463
Phone (201) 447-3603

333 Old Hook Rd
Ste 103
Westwood, NJ 07675
Phone (201) 820-4646

Interoperability endpoints

  • Direct secure messaging: annamma.george.1@5622.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1426809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1205220910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 FRANKLIN TPKE STE 6A",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "074631836",
            "telephone_number": "201-447-3603",
            "fax_number": "201-447-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 FRANKLIN TPKE STE 6A",
            "city": "WALDWICK",
            "state": "NJ",
            "postal_code": "074631836",
            "telephone_number": "201-447-3603",
            "fax_number": "201-447-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "ANNAMMA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-20",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00534600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldwick, NJ

Sources for this page

Verify at the official NPI Registry.