Individual provider Active NPI

Yana Warshawsky

  • Primary Care Nurse Practitioner
  • Glen Rock, NJ
National Provider Identifier
1609697937
Registry record updated Oct 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
26NJ15180000 Issued in NJ
Practice address
275 Dunham PL
Glen Rock, NJ 07452-1229
Phone
(917) 753-4071
NPI assigned
Oct 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 26NJ15180000 NJ Primary

Addresses

Primary practice location

275 Dunham PL
Glen Rock, NJ 07452-1229

Mailing address

275 Dunham PL
Glen Rock, NJ 07452-1229
Phone (917) 753-4071

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241219000869 NJ Practitioner - Geriatric Medicine 5193252807 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26NJ15180000NJMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Service Professionals of NJ LLC CurrentSince Dec 12, 2024 Accepting new patients

Locations

30 Montgomery St
Fl 15
Jersey City, NJ 07302
Phone (551) 247-1029

125 Chubb Ave
Ste 100S
Lyndhurst, NJ 07071
Phone (201) 559-7600

125 Chubb Ave
Ste 100
Lyndhurst, NJ 07071
Phone (201) 559-7600

Organizations & group practices 1

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": "1729296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729296000000",
    "number": "1609697937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 DUNHAM PL",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074521229",
            "telephone_number": "917-753-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 DUNHAM PL",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074521229",
            "telephone_number": "917-753-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARSHAWSKY",
        "first_name": "YANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-19",
        "last_updated": "2024-10-19",
        "certification_date": "2024-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ15180000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Rock, NJ

Sources for this page

Verify at the official NPI Registry.