Individual provider Active NPI

Courtney Alise Carrozza, APN-C

  • Primary Care Nurse Practitioner
  • Princeton, NJ
National Provider Identifier
1396291597
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
26NJ00656600 Issued in NJ
Practice address
3626 Route 1 N
Princeton, NJ 08540-5922
Phone
(609) 945-3611
NPI assigned
Aug 28, 2016
Last updated
Aug 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00656600 NJ
Gerontology Nurse Practitioner 363LG0600X 26NJ00656600 NJ
Primary Care Nurse Practitioner 363LP2300X 26NJ00656600 NJ Primary

Addresses

Primary practice location

3626 Route 1 N
Princeton, NJ 08540-5922

Mailing address

2600 Custer St
Piscataway, NJ 08854-4563
Phone (908) 705-4574

Other practice location 1

2600 Custer St
Piscataway, NJ 08854-4563
Phone (908) 705-4574

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170124001654 NJ Practitioner - Nurse Practitioner 0446532659 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kane Wound Care LLC CurrentSince Jun 13, 2022 Accepting new patients

Locations

93 Manalapan Ave
Freehold, NJ 07728
Phone (732) 303-8800

100 Mazdabrook Rd
#One
Parsippany, NJ 07054
Phone (732) 841-9338

3626 US Highway 1
Princeton, NJ 08540
Phone (609) 243-0445

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": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1396291597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 CUSTER ST",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088544563",
            "telephone_number": "908-705-4574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3626 ROUTE 1 N",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085405922",
            "telephone_number": "609-945-3611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2600 Custer St",
            "address_purpose": "LOCATION",
            "city": "Piscataway",
            "state": "NJ",
            "postal_code": "088544563",
            "country_code": "US",
            "telephone_number": "908-705-4574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROZZA",
        "first_name": "COURTNEY",
        "middle_name": "ALISE",
        "credential": "APN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00656600",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00656600",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ00656600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.