Virginia Atieh, APN
Individual provider Active NPI Primary Care Nurse Practitioner · Holmdel, NJ
NPI 1659778306 · NPPES record last updated Nov 28, 2023
Key facts
- NPI
- 1659778306
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 26NJ00523000 (NJ)
- Practice address
- 2080 Hwy 35
Holmdel, NJ 07733-1090 - Phone
- (609) 890-1050
- Fax
- (609) 890-0950
- NPI assigned
- Nov 24, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- 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 PC
Practice addresses (Care Compare)
2080 State Route 35
Holmdel, NJ 07733-1090
Phone (609) 890-1050
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150105002107 | NJ | Practitioner - Nurse Practitioner | 9436472131 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ00523000 | NJ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Jersey Family Medical Group PA | Current |
Accepting new patients |
Locations
333 Forsgate Dr
Ste 205
Jamesburg, NJ 08831
Phone (732) 274-0928
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 26NJ00523000 | NJ | Yes |
| 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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0445355 | Medicaid | NJ |
Other providers in Holmdel, NJ
- Gaetano J Aquilino
- Robert Arbour
- Evelyn Aina Arigbe
- Ervin David Arredondo
- Laura Atehortua
- Au Medical Supply Inc.
- Audiology Island of New Jersey, PC
- Audiology Services Company USA, LLC
- Christienne Aure
- Aurora Healthcare & Diagnostics PLLC
All providers in Holmdel, NJ · Primary Care Nurse Practitioner in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.