Individual provider Active NPI

Lauren Michelle Pellicane, APN

  • Family Nurse Practitioner
  • Jackson, NJ
National Provider Identifier
1306389689
Registry record updated Nov 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00681500 Issued in NJ
Practice address
27 S Cooks Bridge Rd
Suite 2-1
Jackson, NJ 08527-2524
Phone
(732) 367-0166
NPI assigned
Nov 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2016

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 26NJ00681500 NJ Primary

Addresses

Primary practice location

27 S Cooks Bridge Rd
Suite 2-1
Jackson, NJ 08527-2524

Mailing address

27 S Cooks Bridge Rd.
Suite 2-1
Jackson, NJ 08527
Phone (732) 367-0166

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
I20170221002418 NJ Practitioner - Nurse Practitioner 2567746415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Emergency Medicine Associates, LLCGroup PAC ID 0941612840, 826 clinicians

Practice addresses (Care Compare)

225 Williamson St
Elizabeth, NJ 07202-3625
Phone (908) 994-5422

600 River Ave
Lakewood, NJ 08701-5237
Phone (732) 886-4700

99 Hwy 37 W
Toms River, NJ 08755-6423
Phone (732) 557-8000

99 Rte 37
Toms River, NJ 08755-6423
Phone (732) 557-8013

Hospital & facility affiliations

  • Community Medical Center Hospital, Toms River, NJ, CCN 310041

Merit-based Incentive Payment System (MIPS)

Final score
87.07 of 100Reported as group
Quality
76.5
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00681500NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Emergency Medicine Associates, LLC Family CurrentSince Nov 30, 2020 Accepting new patients

Locations

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

600 River Ave
Lakewood, NJ 08701
Phone (732) 363-1900

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

201 Lyons Ave
#M
Newark, NJ 07112
Phone (800) 843-2384

99 State Route 37 W
Toms River, NJ 08755
Phone (732) 240-8000

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

Interoperability endpoints

  • Direct secure messaging: lpellicane48283@epicdirect.rwjbh.org

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": "1479427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1306389689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 S COOKS BRIDGE RD.",
            "address_2": "SUITE 2-1",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "08527",
            "telephone_number": "732-367-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 S COOKS BRIDGE RD",
            "address_2": "SUITE 2-1",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272524",
            "telephone_number": "732-367-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLICANE",
        "first_name": "LAUREN",
        "middle_name": "MICHELLE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-18",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00681500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, NJ

Sources for this page

Verify at the official NPI Registry.