Individual provider Active NPI

Virginia Atieh, APN

  • Primary Care Nurse Practitioner
  • Holmdel, NJ
National Provider Identifier
1659778306
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
26NJ00523000 Issued in NJ
Practice address
2080 Hwy 35
Holmdel, NJ 07733-1090
Phone
(609) 890-1050
Fax
(609) 890-0950
NPI assigned
Nov 24, 2014
Last updated
Nov 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 26NJ00523000 NJ Primary
Family Nurse Practitioner 363LF0000X 26NJ00523000 NJ

Addresses

Primary practice location

2080 Hwy 35
Holmdel, NJ 07733-1090

Mailing address

2080 Hwy 35
Holmdel, NJ 07733-1090
Phone (732) 706-7200

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
I20150105002107 NJ Practitioner - Nurse Practitioner 9436472131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Azz Medical Associates PCGroup PAC ID 6002132685, 63 clinicians

Practice addresses (Care Compare)

2080 State Route 35
Holmdel, NJ 07733-1090
Phone (609) 890-1050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00523000NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Jersey Family Medical Group PA CurrentSince Jan 2, 2019 Accepting new patients

Locations

333 Forsgate Dr
Ste 205
Jamesburg, NJ 08831
Phone (732) 274-0928

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.

NPI Registry JSON

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1659778306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 HWY 35",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331090",
            "telephone_number": "732-706-7200",
            "fax_number": "973-433-9761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 HWY 35",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331090",
            "telephone_number": "609-890-1050",
            "fax_number": "609-890-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATIEH",
        "first_name": "VIRGINIA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-24",
        "last_updated": "2023-11-28",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ00523000",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00523000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

Verify at the official NPI Registry.