Individual provider Active NPI

Kinga Fryzlewicz (Lebioda)

  • Nurse Practitioner
  • Hackensack, NJ
National Provider Identifier
1417548017
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ01106500 Issued in NJ
Practice address
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone
(551) 996-2000
Fax
(551) 996-4915
NPI assigned
Jan 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ01106500 NJ Primary

Addresses

Primary practice location

30 Prospect Ave
Hackensack, NJ 07601-1915

Mailing address

3600 Route 66
FL 3
Neptune, NJ 07753-2645
Phone (732) 807-0877

Other names 1

  • Kinga Lebioda Professional name

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
I20211015002146 NJ Practitioner - Nurse Practitioner 2365840766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jun 23, 2021 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jun 23, 2021 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

NPI Registry JSON

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1417548017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 66",
            "address_2": "FL 3",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077532645",
            "telephone_number": "732-807-0877",
            "fax_number": "201-751-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-2000",
            "fax_number": "551-996-4915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYZLEWICZ (LEBIODA)",
        "first_name": "KINGA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01106500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KINGA",
            "last_name": "LEBIODA",
            "credential": "APN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.