Individual provider Active NPI

Maria Teresa De Peralta, NURSE PRACTITIONER

  • Nurse Practitioner
  • Monroe, NJ
National Provider Identifier
1386689222
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NN09621900 Issued in NJ
Practice address
351A Northfield LN
Monroe, NJ 08831-1794
Phone
(702) 321-6459
NPI assigned
Jun 17, 2006
Last updated
Apr 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NN09621900 NJ Primary
Adult Health Nurse Practitioner 363LA2200X APN000928 NV

Addresses

Primary practice location

351A Northfield LN
Monroe, NJ 08831-1794

Mailing address

351A Northfield LN
Monroe, NJ 08831-1794
Phone (702) 321-6459

Other identifiers 1

IdentifierTypeStateIssuer
0003565MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NV, NH3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20110608000674 NJ Practitioner - Nurse Practitioner 9335326933 Reassigns benefits to 1 organization
I20230309002442 NV Practitioner - Nurse Practitioner 9335326933 Reassigns benefits to 1 organization
I20240604003896 NH Practitioner - Nurse Practitioner 9335326933 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN000928NVMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates of New Jersey, LLC Nurse Practitioner CurrentSince Sep 27, 2023 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Jan 1, 2023 Accepting new patients
My Home Doctor, LLC Nurse Practitioner Past Accepting new patients

Locations

116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 650-7800

701 S Carson St
Ste 200
Carson City, NV 89701
Phone (617) 586-0958

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 600
Dallas, TX 75244

Organizations & group practices 3

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1386689222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351A NORTHFIELD LN",
            "city": "MONROE",
            "state": "NJ",
            "postal_code": "088311794",
            "telephone_number": "702-321-6459",
            "fax_number": "888-294-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351A NORTHFIELD LN",
            "city": "MONROE",
            "state": "NJ",
            "postal_code": "088311794",
            "telephone_number": "702-321-6459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE PERALTA",
        "first_name": "MARIA TERESA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NN09621900",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NV",
            "license": "APN000928",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0003565",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NJ

Sources for this page

Verify at the official NPI Registry.