Tatum Ann Vitale, APN-C
Individual provider Active NPI Nurse Practitioner · Red Bank, NJ
NPI 1457071763 · NPPES record last updated Aug 29, 2022
Key facts
- NPI
- 1457071763
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 26NJ01359700 (NJ)
- Practice address
- 1 Riverview PLZ
Red Bank, NJ 07701-1864 - Phone
- (732) 530-2279
- NPI assigned
- Aug 29, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 8
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hackensack Meridian Health Medical Group - Specialty Care PC
Practice addresses (Care Compare)
20 Prospect Ave
Hackensack, NJ 07601-1997
Phone (551) 996-5045
Hospital & facility affiliations
- Riverview Medical Center
- Bayshore Medical Center
- Monmouth Medical Center
- Ocean Medical Center
- JFK University Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.33 of 100
- Quality
- 66.38
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.39
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230131000723 | NJ | Practitioner - Nurse Practitioner | 9234500224 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ01359700 | NJ | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current |
Accepting new patients | |
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current |
Accepting new patients | |
| Hackensack Meridian Health Medical Group - Complex Care PC | Past | Accepting new patients | |
| Meridian Medical Group - Specialty Care, PC | Past | Accepting new patients |
Locations
135 NJ 35
Eatontown, NJ 07724
Phone (848) 308-4911
30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066
20 Prospect Ave
Hackensack, NJ 07601
Phone (201) 996-2816
733 N Beers St
Ste U3
Holmdel, NJ 07733
Phone (732) 264-8484
1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IHJHBD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 26NJ01359700 | NJ | Yes |
Addresses
Primary practice location
1 Riverview PLZ
Red Bank, NJ 07701-1864
Mailing address
612 Dow Ave
Oakhurst, NJ 07755-2815
Other practice location 1
612 Dow Ave
Oakhurst, NJ 07755-2815
Phone (201) 602-1379
Other providers in Red Bank, NJ
- Vera Veronica Viran
- Lauren Viscusi
- Visiting Nurse Association of Central Jersey Community Health Center I
- Visiting Nurse Association of Central Jersey Personal Care, Inc
- Amelia Rose Vitale
- Vitality Integrative Health & Acupuncture LLC
- VLR Med LLC
- William Christopher Vockroth
- Semyon Volman
- Zelda Wachman
All providers in Red Bank, NJ · Nurse Practitioner in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.