Nicole Marie Douglas, APN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ01103800 Issued in NJ

Practice address

415 Route 24 Ste E
Chester, NJ 07930-2920

Phone

(908) 879-1500

NPI assigned

Jan 19, 2021

Last updated

Jan 19, 2021By the provider in NPPES

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

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Cardiology LLCGroup PAC ID 5597751735, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Morristown Medical Center Hospital, Morristown, NJ, CCN 310015

Merit-based Incentive Payment System (MIPS)

Final score

87.16 of 100Reported as group

Quality

78.12

Promoting interoperability

100

Improvement activities

40

Cost

79.08

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

• Advanced Cardiology, LLC

  dba Advanced Physical Therapy

  • Cardiovascular Disease Physician
  • Cedar Knolls, NJ
  • NPI 1295871796

  Adult Health

  Medicare reassignment Care Compare group NPD
• Consensus Medical Group LLC

  • Internal Medicine Physician
  • Manasquan, NJ
  • NPI 1811466881
  Medicare reassignment NPD
• Lawrence C. Antonucci MD LLC

  • Cardiovascular Disease Physician
  • Chester, NJ
  • NPI 1023092368
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahs Hospital Corp.

  dba Morristown Medical Center

  • General Acute Care Hospital
  • Morristown, NJ
  • NPI 1053384776
  Care Compare affiliation

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1215527874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 REDWOOD RD",
            "city": "MARTINSVILLE",
            "state": "NJ",
            "postal_code": "088362373",
            "telephone_number": "732-977-8506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 ROUTE 24 STE E",
            "city": "CHESTER",
            "state": "NJ",
            "postal_code": "079302920",
            "telephone_number": "908-879-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ01103800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Anne Dicola, C.A.
• Lisa Marie Diferdinando, RN
• Carey Dolgin, MD
• Maryanna Vrettos Domenic
• Michael Gerard Donnelly Sr., MD
• Douglas William Downs, OTR
• Dr Karen a Tennyson LLC
• Dr Megan Cox LLC
• Nicole D Drew, MSPT
• Michelle Durkin, MA, LPC, CFRC, NCC

• Adult Health Nurse Practitioner in Chester, NJ
• Providers in Chester, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.