Individual provider Active NPI

Jessica A Timmerman, MS-FNP

  • Family Nurse Practitioner
  • Marlboro, NJ
National Provider Identifier
1225477904
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00454800 Issued in NJ
Practice address
4 Ryan Rd
Marlboro, NJ 07746-2445
Phone
(866) 389-2727
NPI assigned
Jun 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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 F338012 NY
Family Nurse Practitioner 363LF0000X 26NJ00454800 NJ Primary

Addresses

Primary practice location

4 Ryan Rd
Marlboro, NJ 07746-2445

Mailing address

1 Woodland Ave
Cream Ridge, NJ 08514-2335
Phone (732) 580-2589

Other names 1

  • Jessica A Eadicicco Former name

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
I20131029000540 NJ Practitioner - Nurse Practitioner 4587899562 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

368 Lakehurst Rd
Suite 206
Toms River, NJ 08755-7339
Phone (732) 557-9980

595 Division St
Elizabeth, NJ 07201-2038
Phone (908) 289-5646

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
338012NYMDLicensed Practical Nurse
26NJ00454800NJMDFamily Nurse Practitioner
F338012NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of New Jersey PA Current Accepting new patients
Barnabas Health Medical Group, PC CurrentSince Aug 4, 2019 Accepting new patients
American Current Care of New Jersey, P.a. CurrentSince Oct 7, 2024 Accepting new patients
American Current Care of New Jersey PA CurrentSince Oct 7, 2024 Accepting new patients

Locations

595 Division St
Elizabeth, NJ 07201
Phone (908) 289-5646

817 E Gate Dr
#102
Mount Laurel, NJ 08054
Phone (856) 778-1090

223 Monmouth Rd
West Long Branch, NJ 07764
Phone (732) 229-3838

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 4

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": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1225477904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WOODLAND AVE",
            "city": "CREAM RIDGE",
            "state": "NJ",
            "postal_code": "085142335",
            "telephone_number": "732-580-2589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 RYAN RD",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077462445",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMMERMAN",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "MS-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F338012",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00454800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "EADICICCO",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marlboro, NJ

Sources for this page

Verify at the official NPI Registry.