Individual provider Active NPI

Daria Korneva

  • Nurse Practitioner
  • Bayonne, NJ
National Provider Identifier
1609532183
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ01226500 Issued in NJ
Practice address
988 Broadway
Bayonne, NJ 07002-4036
Phone
(201) 339-6111
NPI assigned
Nov 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ01226500 NJ Primary

Addresses

Primary practice location

988 Broadway
Bayonne, NJ 07002-4036

Mailing address

29 Springbrook Ave
North Haledon, NJ 07508-2537
Phone (862) 232-1902

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
I20220728002821 NJ Practitioner - Nurse Practitioner 0749662344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
BHMG - United MedicalGroup PAC ID 5193949865, 28 clinicians

Practice addresses (Care Compare)

988 Broadway
Suite 201
Bayonne, NJ 07002-4036
Phone (201) 339-6111

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
BHMG - United Medical CurrentSince Apr 20, 2022 Accepting new patients
Rapid Access Medical Diagnostics NJ LLC PastSince Feb 1, 2022 Accepting new patients

Locations

988 Broadway
Bayonne, NJ 07002
Phone (201) 339-6111

988 Broadway
Ste 1
Bayonne, NJ 07002

988 Broadway
Ste 201
Bayonne, NJ 07002
Phone (201) 339-6111

533 Lexington Ave
Ste 1
Clifton, NJ 07011

533 Lexington Ave
Clifton, NJ 07011
Phone (973) 546-6844

612 Rutherford Ave
Lyndhurst, NJ 07071
Phone (200) 460-0063

Interoperability endpoints

  • Direct secure messaging: dkorneva123914@epicdirect.rwjbh.org

Organizations & group practices 2

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": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1609532183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 SPRINGBROOK AVE",
            "city": "NORTH HALEDON",
            "state": "NJ",
            "postal_code": "075082537",
            "telephone_number": "862-232-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024036",
            "telephone_number": "201-339-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNEVA",
        "first_name": "DARIA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01226500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

Verify at the official NPI Registry.