Individual provider Active NPI

Berdine Macasero

  • Family Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1497116156
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00458900 Issued in NJ
Practice address
Newark Liberty Airport, Terminal C
Room #136
Newark, NJ 07114
Phone
(973) 681-1700
NPI assigned
Mar 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00458900 NJ Primary

Addresses

Primary practice location

Newark Liberty Airport, Terminal C
Room #136
Newark, NJ 07114

Mailing address

Newark Liberty Airport, Terminal C
Room #136
Newark, NJ 07114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00458900NJMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: berdine.macasero.p55@direct.medcor.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1457481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1497116156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NEWARK LIBERTY AIRPORT, TERMINAL C",
            "address_2": "ROOM #136",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NEWARK LIBERTY AIRPORT, TERMINAL C",
            "address_2": "ROOM #136",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07114",
            "telephone_number": "973-681-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACASERO",
        "first_name": "BERDINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-09",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00458900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.