Kourtnie Fedele, DNP, RN, CPNP-AC/PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

26NJ14943000 Issued in NJ

Practice address

222 Grand St Apt 3D
Hoboken, NJ 07030-2589

Phone

(917) 682-7414

NPI assigned

Feb 10, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

Practice roles

Locations

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.

• Robert Wood Johnson Medical Associates

  • Hospitalist Physician
  • New Brunswick, NJ
  • NPI 1902848625
  Medicare reassignment NPD

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1487045639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 GRAND ST APT 3D",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070302589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 GRAND ST APT 3D",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070302589",
            "telephone_number": "917-682-7414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDELE",
        "first_name": "KOURTNIE",
        "name_prefix": "Ms.",
        "credential": "DNP, RN, CPNP-AC/PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-10",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NJ14943000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nardeen Farag
• Sherman Farahani, DDS
• Lauren Farco
• Gloria Maria Farfan, LCSW
• Alfred O Fayemi, MD
• Samantha Ann Feliz, LAC, NCC
• Laura Ferland, RDN
• Adolfo Carlos Fernandez-Obregon, M.D.
• Osbert Fernandez, MD
• Shannan Rae Ferrari, PA-C

• Pediatric Nurse Practitioner in Hoboken, NJ
• Providers in Hoboken, NJ by specialty
• Pediatric Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.