Active NPI
Lisa Endanattu, FNP-BC
- Family Nurse Practitioner
- Nutley, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 350529
- Practice address
- 88 Park Ave Ste 2a
Nutley, NJ 07110-3500 - Phone
- (973) 571-2121
- NPI assigned
- Oct 11, 2022
- Last updated
- Oct 11, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 350529 | NY | Primary |
Addresses
Primary practice location
88 Park Ave Ste 2a
Nutley, NJ 07110-3500
Mailing address
9 E Palisades Ave
Nanuet, NY 10954-3345
Phone (845) 709-1490
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
88 Park Ave
Suite 2a
Nutley, NJ 07110-3500
Phone (973) 571-2121
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 350529 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Schweiger Dermatology, PC | Current | Accepting new patients | |
| The Dermatology Group | Current | Accepting new patients |
Locations
2 Hudson Pl
Ste 101
Hoboken, NJ 07030
Phone (201) 731-4240
315 E Northfield Rd
Ste 2A
Livingston, NJ 07039
Phone (973) 535-3200
712 E Bay Ave
Ste 18
Manahawkin, NJ 08050
88 Park Ave
Ste 2A
Nutley, NJ 07110
Phone (973) 434-1402
44 State Rt 23
Ste 213
Riverdale, NJ 07457
95 Woodstown Rd
Ste B
Swedesboro, NJ 08085
Phone (856) 358-1500
2701 Queens Plz N
Fl 10
Long Island City, NY 11101
Phone (203) 996-6379
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dermatology Physician
- Elmer, NJ
- NPI 1104229392
-
- Dermatology Physician
- West Orange, NJ
- NPI 1962428474
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1665446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665446400000",
"number": "1639894793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 E PALISADES AVE",
"city": "NANUET",
"state": "NY",
"postal_code": "109543345",
"telephone_number": "845-709-1490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "88 PARK AVE STE 2A",
"city": "NUTLEY",
"state": "NJ",
"postal_code": "071103500",
"telephone_number": "973-571-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENDANATTU",
"first_name": "LISA",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-11",
"last_updated": "2022-10-11",
"certification_date": "2022-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "350529",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Nutley, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.