Individual provider Active NPI

Jezabel Mariela Novo-Frias, APN

  • Nurse Practitioner
  • New Providence, NJ
National Provider Identifier
1336590355
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00633100 Issued in NJ
Practice address
550 Central Ave Ste 500
New Providence, NJ 07974-1505
Phone
(908) 795-1194
Fax
(908) 522-5999
NPI assigned
Jun 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ00633100 NJ Primary

Addresses

Primary practice location

550 Central Ave Ste 500
New Providence, NJ 07974-1505

Mailing address

PO Box 416457
Boston, MA 02241-4147
Phone (844) 362-1735

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
I20170302000803 NJ Practitioner - Nurse Practitioner 7416231873 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00633100NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Dec 26, 2023 Accepting new patients
Garden State Cardiovascular Specialists P.C CurrentSince Jan 1, 2017 Accepting new patients

Locations

520 N Wood Ave
Linden, NJ 07036
Phone (908) 587-1330

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

550 Central Ave
Ste 500
New Providence, NJ 07974
Phone (908) 795-1192

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1336590355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022414147",
            "telephone_number": "844-362-1735",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 CENTRAL AVE STE 500",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079741505",
            "telephone_number": "908-795-1194",
            "fax_number": "908-522-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVO-FRIAS",
        "first_name": "JEZABEL",
        "middle_name": "MARIELA",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00633100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Providence, NJ

Sources for this page

Verify at the official NPI Registry.