Agnieszka Golabek, A.P.N.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ00563700 Issued in NJ

Practice address

714 10TH St
Secaucus, NJ 07094-2921

Phone

(201) 368-1717

Fax

(201) 368-9618

NPI assigned

May 7, 2015

Last updated

Nov 29, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Evergreen Medical Group PCGroup PAC ID 2769929082, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Evergreen Medical Group PC

  • Physical Medicine & Rehabilitation Physician
  • River Edge, NJ
  • NPI 1295516409

  Adult Health

  Medicare reassignment Care Compare group NPD
• Tri-State Health and Wellness Medical Care Center PC

  • Health Service Clinic/Center
  • Fair Lawn, NJ
  • NPI 1942457023
  Medicare reassignment NPD
• Optum Medical Care of New Jersey PC

  • Pediatrics Physician
  • New Hyde Park, NY
  • NPI 1578665048

  NJ

  Medicare reassignment NPD
• Dynamic Health Rehabilitation Center PC

  • Specialist
  • Fair Lawn, NJ
  • NPI 1588077705
  NPD
• Optum Medical Care of New Jersey PC

  dba Riverside Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Belleville, NJ
  • NPI 1255050902
  NPD

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1346628567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 10TH ST",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942921",
            "telephone_number": "201-368-1717",
            "fax_number": "201-368-9618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 10TH ST",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942921",
            "telephone_number": "201-368-1717",
            "fax_number": "201-368-9618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLABEK",
        "first_name": "AGNIESZKA",
        "credential": "A.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-07",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00563700",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00563700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garden State Adult Medical Day Care Center LLC
• Nicole Rose Garey, PA-C
• Amy Gargin, DPT
• Marigona Gashi, PA-C
• Gerard a Marra Sr Inc (Marras Drug Store)
• Angie Gomez
• Licelot Gonzalez, RBT
• Kevin Goodman
• Manasa Nidagalle Gowda, DO
• Jihana Graves, LSW

• Adult Health Nurse Practitioner in Secaucus, NJ
• Providers in Secaucus, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.

Verify at the official NPI Registry.