Individual provider Active NPI

Marcy J Kunnipparampil

  • Family Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1669956827
Registry record updated Sep 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00840300 Issued in NJ
Practice address
150 Bergen St
Newark, NJ 07103-2496
Phone
(973) 972-5000
NPI assigned
Sep 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00840300 NJ Primary

Addresses

Primary practice location

150 Bergen St
Newark, NJ 07103-2496

Mailing address

25 Melrose Dr
Livingston, NJ 07039-2454
Phone (201) 283-4291

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
I20200520001917 NJ Practitioner - Nurse Practitioner 9830520154 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00840300NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital CurrentSince May 1, 2020 Accepting new patients
University Hospital CurrentSince May 1, 2020 Accepting new patients

Locations

150 Bergen St
Rm M219
Newark, NJ 07103
Phone (973) 972-1193

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

Interoperability endpoints

  • FHIR API: https://epicproxy.et0434.epichosted.com/APIProxyPRD/UHNJ/api/FHIR/R4

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": "1537660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537660800000",
    "number": "1669956827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MELROSE DR",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070392454",
            "telephone_number": "201-283-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNNIPPARAMPIL",
        "first_name": "MARCY",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-23",
        "last_updated": "2018-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00840300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.