Individual provider Active NPI

Adrienne Pannullo

  • Family Nurse Practitioner
  • Hoboken, NJ
National Provider Identifier
1225896152
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F353436-01 Issued in NY
Practice address
1030 Willow Ave Apt 1
Hoboken, NJ 07030-3396
Phone
(732) 670-6538
NPI assigned
Mar 6, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F353436-01 NY Primary

Addresses

Primary practice location

1030 Willow Ave Apt 1
Hoboken, NJ 07030-3396

Mailing address

1030 Willow Ave Apt 1
Hoboken, NJ 07030-3396
Phone (732) 670-6538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240612001509 NY Practitioner - Nurse Practitioner 6103368683 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F353436-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mskcc Surgery Group CurrentSince May 19, 2024 Accepting new patients

Locations

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: apannullo238544@mskcc.direct-ci.com

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": "1709683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1225896152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 WILLOW AVE APT 1",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070303396",
            "telephone_number": "732-670-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 WILLOW AVE APT 1",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070303396",
            "telephone_number": "732-670-6538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANNULLO",
        "first_name": "ADRIENNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F353436-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

Verify at the official NPI Registry.