Individual provider Active NPI

Nina Vaskina Andreyev, M.D.

  • Internal Medicine Physician
  • Brick, NJ
National Provider Identifier
1386655082
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA074104 Issued in NJ
Practice address
970 Route 70
Brick, NJ 08724-3502
Phone
(732) 206-8900
NPI assigned
Aug 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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
Internal Medicine Physician 207R00000X 25MA074104 NJ Primary

Addresses

Primary practice location

970 Route 70
Brick, NJ 08724-3502

Mailing address

10 Arrowwood CT
Howell, NJ 07731-5027
Phone (732) 303-8190

Other identifiers 1

IdentifierTypeStateIssuer
9001701MedicaidNJ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130405000443 NJ Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 1951361625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA074104NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Orange Vamc PastSince Dec 1, 2021 Accepting new patients

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, 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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386655082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 ARROWWOOD CT",
            "city": "HOWELL",
            "state": "NJ",
            "postal_code": "077315027",
            "telephone_number": "732-303-8190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 ROUTE 70",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243502",
            "telephone_number": "732-206-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREYEV",
        "first_name": "NINA",
        "middle_name": "VASKINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA074104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9001701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.