Patricia Acevedo, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

26NJ01223800 Issued in NJ

Practice address

2 E Blackwell St Ste 18
Dover, NJ 07801-4645

Phone

(973) 939-1150

Fax

(973) 939-1151

NPI assigned

Nov 9, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1497411979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 ROBERT ST",
            "city": "WHARTON",
            "state": "NJ",
            "postal_code": "078852134",
            "telephone_number": "973-207-8226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 E BLACKWELL ST STE 18",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078014645",
            "telephone_number": "973-939-1150",
            "fax_number": "973-939-1151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 Parsippany Rd",
            "address_purpose": "LOCATION",
            "city": "Parsippany",
            "state": "NJ",
            "postal_code": "070545192",
            "country_code": "US",
            "telephone_number": "973-884-0666",
            "fax_number": "973-560-9166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACEVEDO",
        "first_name": "PATRICIA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01223800",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ01223800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.