Active NPI
Courtney Elizabeth Hennelly, APN
- Family Nurse Practitioner
- Basking Ridge, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 33 334424
- Practice address
- 136 Mountainview Blvd
Basking Ridge, NJ 07920-3444 - Phone
- (908) 542-3500
- Fax
- (908) 542-3211
- NPI assigned
- Aug 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 26NJ00345800 | NJ | |
| Family Nurse Practitioner | 363LF0000X | 33 334424 | NY | Primary |
Addresses
Primary practice location
136 Mountainview Blvd
Basking Ridge, NJ 07920-3444
Mailing address
136 Mountainview Blvd
Basking Ridge, NJ 07920-3444
Phone (908) 542-3500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
136 Mountain View Blvd
Basking Ridge, NJ 07920-3444
136 Mountainview Blvd
Basking Ridge, NJ 07920-3444
Phone (908) 542-3000
Hospital & facility affiliations
- Memorial Hospital for Cancer and Allied Diseases
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.57 of 100
- Quality
- 72.31
- Improvement activities
- 40
- Cost
- 76.55
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ00345800 | NJ | MD | Family Nurse Practitioner |
| 33 334424 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Pediatric Group | Current | Accepting new patients | |
| Memorial Sloan Kettering Cancer Center at Basking Ridge New Jersey | Current | Accepting new patients |
Locations
136 Mountainview Blvd
Basking Ridge, NJ 07920
Phone (908) 542-3000
480 Red Hill Rd
Middletown, NJ 07748
Phone (908) 542-3007
633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000
1275 York Ave
New York, NY 10065
Phone (212) 639-3813
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- chennelly39189@mskcc.direct-ci.com
Organizations & group practices 2
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.
-
- Medical Oncology Physician
- Basking Ridge, NJ
- NPI 1184637886
-
- Pediatrics Physician
- New York, NY
- NPI 1750352381
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Basking Ridge, NJ
- NPI 1659385474
-
- General Acute Care Hospital
- Montvale, NJ
- NPI 1841650330
-
- General Acute Care Hospital
- Middletown, NJ
- NPI 1528428521
-
- General Acute Care Hospital
- New York, NY
- NPI 1700887411
-
- Special Hospital
- New York, NY
- NPI 1770046351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332288000000",
"number": "1265623763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 MOUNTAINVIEW BLVD",
"city": "BASKING RIDGE",
"state": "NJ",
"postal_code": "079203444",
"telephone_number": "908-542-3500",
"fax_number": "908-542-3211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 MOUNTAINVIEW BLVD",
"city": "BASKING RIDGE",
"state": "NJ",
"postal_code": "079203444",
"telephone_number": "908-542-3500",
"fax_number": "908-542-3211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENNELLY",
"first_name": "COURTNEY",
"middle_name": "ELIZABETH",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-08",
"last_updated": "2012-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NJ",
"license": "26NJ00345800",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "33 334424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Basking Ridge, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.