Caren Bautista Mamaradlo

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

26NJ15234000 Issued in NJ

Practice address

346 Hamilton Dr
Stewartsville, NJ 08886-2649

Phone

(201) 306-7333

NPI assigned

Jan 7, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Etheridge Family Medicine, L.L.C.

  • Family Medicine Physician
  • Somerset, NJ
  • NPI 1700954476
  Medicare reassignment

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

{
    "created_epoch": "1736208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1538978176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 HAMILTON DR",
            "city": "STEWARTSVILLE",
            "state": "NJ",
            "postal_code": "088862649",
            "telephone_number": "201-306-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 HAMILTON DR",
            "city": "STEWARTSVILLE",
            "state": "NJ",
            "postal_code": "088862649",
            "telephone_number": "201-306-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMARADLO",
        "first_name": "CAREN",
        "middle_name": "BAUTISTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ15234000",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ15234000",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ15234000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorcas Lofack Todom, NP
• Jennifer Gae Long, PT
• Elaine Maddumba Magat
• Mahanaim Sanctuary a NJ Nonprofit Corporation
• Mahanaim Sanctuary a NJ Nonprofit Corporation
• Amy Lynn Murray
• John O'Mahony
• Rem New Jersey, Inc.
• Rem New Jersey, Inc.
• Kristin Rutan, APN

• Primary Care Nurse Practitioner in Stewartsville, NJ
• Providers in Stewartsville, NJ by specialty
• Primary Care Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.