Individual provider Active NPI

Maria Miljutina, NP

  • Adult Health Nurse Practitioner
  • Freehold, NJ
National Provider Identifier
1508458704
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ01098200 Issued in NJ
Practice address
103 Koster Dr
Freehold, NJ 07728-2835
Phone
(347) 761-8593
NPI assigned
Feb 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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 26NJ01098200 NJ Primary

Addresses

Primary practice location

103 Koster Dr
Freehold, NJ 07728-2835

Mailing address

103 Koster Dr
Freehold, NJ 07728-2835
Phone (347) 761-8593

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
I20220725002393 NJ Practitioner - Nurse Practitioner 8224419049 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allied Digestive Health LLCGroup PAC ID 5991027583, 282 clinicians

Practice addresses (Care Compare)

1912 State Route 35
Oakhurst, NJ 07755-2768
Phone (732) 389-5004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01098200NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Digestive Health, LLC CurrentSince Aug 1, 2023 Accepting new patients
Atlantic Coast Gastroenterology Associates Past Accepting new patients

Locations

148 Engle St
Englewood, NJ 07631
Phone (201) 408-5505

1912 State Route 35
Ste 201
Oakhurst, NJ 07755
Phone (732) 389-5004

42 Throckmorton Ln
Old Bridge, NJ 08857
Phone (732) 607-1111

140 E Ridgewood Ave
Ste 415
Paramus, NJ 07652
Phone (201) 720-1900

1640 Route 88 W
Ste 202
Wall Township, NJ 08724
Phone (732) 370-2220

Interoperability endpoints

  • Direct secure messaging: mmiljutina449147@direct.ahsys.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1508458704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 KOSTER DR",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282835",
            "telephone_number": "347-761-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 KOSTER DR",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282835",
            "telephone_number": "347-761-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILJUTINA",
        "first_name": "MARIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ01098200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.