Individual provider Active NPI

Liza M Marmo, APN

  • Adult Health Nurse Practitioner
  • Hillsborough, NJ
National Provider Identifier
1609208511
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00464100 Issued in NJ
Practice address
105 Raider Blvd
Suite 101
Hillsborough, NJ 08844-1528
Phone
(908) 281-0221
Fax
(908) 281-0940
NPI assigned
Aug 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X S013011 PA
Adult Health Nurse Practitioner 363LA2200X 26NJ00464100 NJ Primary

Addresses

Primary practice location

105 Raider Blvd
Suite 101
Hillsborough, NJ 08844-1528

Mailing address

105 Raider Blvd
Suite 101
Hillsborough, NJ 08844-1528
Phone (908) 281-0221

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
I20140430000677 NJ Practitioner - Nurse Practitioner 0840420774 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Id Care LLCGroup PAC ID 7719959998, 119 clinicians

Practice addresses (Care Compare)

105 Raider Blvd
Suite 101
Hillsborough, NJ 08844-1528
Phone (908) 281-0221

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.51 of 100Reported as group
Quality
49.12
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S013011PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Wood Johnson Physician Enterprise CurrentSince Dec 11, 2014 Accepting new patients
Id Care LLC CurrentSince Nov 1, 2016 Accepting new patients
Vibrant Nutrition & Wellness, LLC Past Accepting new patients

Locations

105 Raider Blvd
Ste 101
Hillsborough, NJ 08844
Phone (908) 281-0221

10 Forrestal Rd S
Ste 203
Princeton, NJ 08540
Phone (609) 759-2750

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

97 Cedar Grove Ln
Ste 203
Somerset, NJ 08873
Phone (732) 356-7600

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1609208511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 RAIDER BLVD",
            "address_2": "SUITE 101",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088441528",
            "telephone_number": "908-281-0221",
            "fax_number": "908-281-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 RAIDER BLVD",
            "address_2": "SUITE 101",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088441528",
            "telephone_number": "908-281-0221",
            "fax_number": "908-281-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMO",
        "first_name": "LIZA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-01",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "S013011",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00464100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsborough, NJ

Sources for this page

Verify at the official NPI Registry.