Individual provider Active NPI

Anie G Shiby, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Somerset, NJ
National Provider Identifier
1407561905
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NJ01410400 Issued in NJ
Practice address
3 Dartmoor Dr
Somerset, NJ 08873-4883
Phone
(718) 702-8577
NPI assigned
Jan 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 26NJ01410400 NJ Primary

Addresses

Primary practice location

3 Dartmoor Dr
Somerset, NJ 08873-4883

Mailing address

3 Dartmoor Dr
Somerset, NJ 08873-4883
Phone (718) 702-8577

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
I20240202000257 NJ Practitioner - Nurse Practitioner 7719330059 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Emergency Medicine Associates, LLCGroup PAC ID 0941612840, 826 clinicians

Practice addresses (Care Compare)

355 Grand St
Jersey City, NJ 07302-4321
Phone (201) 915-2000

Hospital & facility affiliations

  • Robert Wood Johnson University Hospital - Somerset Hospital, Somerville, NJ, CCN 310048

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NJ01410400NJMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Observation Associates LLC Acute Care CurrentSince Dec 19, 2023 Accepting new patients
Rwjbh Emergency Medicine Associates, LLC Acute Care CurrentSince Dec 10, 2023 Accepting new patients

Locations

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

600 River Ave
Lakewood, NJ 08701
Phone (732) 363-1900

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1407561905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 DARTMOOR DR",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088734883",
            "telephone_number": "718-702-8577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 DARTMOOR DR",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088734883",
            "telephone_number": "718-702-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIBY",
        "first_name": "ANIE",
        "middle_name": "G",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ01410400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

Verify at the official NPI Registry.