Individual provider Active NPI

Sospeter Obiero, APN

  • Gerontology Nurse Practitioner
  • East Orange, NJ
National Provider Identifier
1265567788
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ00121700 Issued in NJ
Practice address
613 Park Ave
East Orange, NJ 07017-1905
Phone
(973) 676-0955
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ00121700 NJ Primary

Addresses

Primary practice location

613 Park Ave
East Orange, NJ 07017-1905

Mailing address

613 Park Ave
East Orange, NJ 07017-1905
Phone (973) 676-0955

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
I20070606000046 NJ Practitioner - Nurse Practitioner 0244338861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preventive and Diagonostic Medical Center P.a.Group PAC ID 2365410206, 3 clinicians

Practice addresses (Care Compare)

27 S Franklin Tpke
Suite 201
Ramsey, NJ 07446-2550
Phone (201) 818-6800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Preventive and Diagonostic Medical Center P.a. CurrentSince May 1, 2017 Accepting new patients

Locations

27 S Franklin Tpke
Ste 201
Ramsey, NJ 07446
Phone (201) 818-0960

27 S Franklin Tpke
Ramsey, NJ 07446
Phone (201) 327-2248

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.

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265567788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 PARK AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070171905",
            "telephone_number": "973-676-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 PARK AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070171905",
            "telephone_number": "973-676-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBIERO",
        "first_name": "SOSPETER",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00121700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Orange, NJ

Sources for this page

Verify at the official NPI Registry.