Individual provider Active NPI

Kelli Soares

  • Adult Health Nurse Practitioner
  • Eatontown, NJ
National Provider Identifier
1477944635
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00548600 Issued in NJ
Practice address
615 Hope Rd
Eatontown, NJ 07724-1277
Phone
(732) 571-1000
NPI assigned
Feb 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00548600 NJ Primary

Addresses

Primary practice location

615 Hope Rd
Eatontown, NJ 07724-1277

Mailing address

615 Hope Rd 5a
Visiting Physican Services
Eatontown, NJ 07724
Phone (732) 571-1000

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
I20160121000360 NJ Practitioner - Nurse Practitioner 8224331574 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VPS Medical Services, PCGroup PAC ID 2961836069, 45 clinicians

Practice addresses (Care Compare)

3600 State Route 66
Neptune, NJ 07753-2645

Hospital & facility affiliations

  • Valley Home Care Inc. Home health agency, Paramus, NJ, CCN 317008
  • Visiting Nurse Association of Englewood, Inc Home health agency, Englewood, NJ, CCN 317022
  • Amedisys Home Health Home health agency, Hackensack, NJ, CCN 317047
  • Visiting Health Services of New Jersey Home health agency, Woodland Park, NJ, CCN 317058

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
VPS Medical Services, PC CurrentSince Jan 1, 2020 Accepting new patients
Visiting Nurse Association of Central Jersey, Inc. CurrentSince Nov 2, 2015 Accepting new patients

Locations

23 Main St
#D1
Holmdel, NJ 07733
Phone (732) 224-6914

3600 State Route 66
Fl 4
Tinton Falls, NJ 07753
Phone (732) 241-4194

1100 Wayside Rd
Tinton Falls, NJ 07712
Phone (732) 493-2220

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kelli.soares.p2@direct.vnahg.nextgenshare.com

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 4

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": "1423526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1477944635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 HOPE RD 5A",
            "address_2": "VISITING PHYSICAN SERVICES",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "07724",
            "telephone_number": "732-571-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 HOPE RD",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241277",
            "telephone_number": "732-571-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOARES",
        "first_name": "KELLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-10",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00548600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatontown, NJ

Sources for this page

Verify at the official NPI Registry.