Individual provider Active NPI

Djenane Bartholomew, RN

  • Home Health Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1255582599
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
26NR13685400 Issued in NJ
Practice address
517 53Rd St
Brooklyn, NY 11220-2736
Phone
(516) 852-2463
NPI assigned
Oct 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 523142-1 NY
Adult Health Nurse Practitioner 363LA2200X F310460-01 NY
Home Health Registered Nurse 163WH0200X 26NR13685400 NJ Primary

Addresses

Primary practice location

517 53Rd St
Brooklyn, NY 11220-2736

Mailing address

23 Dora LN
Holmdel, NJ 07733-1624
Phone (732) 888-1355

Other practice location 1

23 Dora Ln
Holmdel, NJ 07733-1624
Phone (732) 888-1355

Other names 1

  • Mrs. Djenane Thibaut Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
523142-1NYMDRegistered Nurse
26NR13685400NJMDHome Health Registered Nurse
F310460-01NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Onsite Lifecare, Inc. Past Accepting new patients

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": "1223251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1255582599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 DORA LN",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331624",
            "telephone_number": "732-888-1355",
            "fax_number": "732-888-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 53RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202736",
            "telephone_number": "516-852-2463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23 Dora Ln",
            "address_purpose": "LOCATION",
            "city": "Holmdel",
            "state": "NJ",
            "postal_code": "077331624",
            "country_code": "US",
            "telephone_number": "732-888-1355",
            "fax_number": "732-888-1639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARTHOLOMEW",
        "first_name": "DJENANE",
        "name_prefix": "Dr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-06",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "523142-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F310460-01",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NJ",
            "license": "26NR13685400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DJENANE",
            "last_name": "THIBAUT",
            "prefix": "MRS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.