Kristen Ennis, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00453200 Issued in NJ

Practice address

30 Prospect Ave
Hackensack, NJ 07601-1915

Phone

(551) 996-4078

Fax

(551) 996-4140

NPI assigned

Aug 6, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rutgers Health-RWJ Scleroderma ProgramGroup PAC ID 5193764991, 390 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Robert Wood Johnson University Hospital Hospital, New Brunswick, NJ, CCN 310038

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristen.ennis.p5@direct.cvr.nextgenshare.com
• FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

• Rutgers Health-RWJ Scleroderma Program

  • Allergy & Immunology (Internal Medicine) Physician
  • New Brunswick, NJ
  • NPI 1679655781

  NJ

  Medicare reassignment Care Compare group NPD
• Hackensack Meridian Health Medical Group - Complex Care PC

  • Internal Medicine Physician
  • Red Bank, NJ
  • NPI 1154379626

  NJ

  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249

  NJ

  Medicare reassignment NPD
• Robert Wood Johnson Medical Associates

  • Hospitalist Physician
  • New Brunswick, NJ
  • NPI 1902848625

  NJ

  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD
• Rutgers Health-RWJ Scleroderma Program

  • Psychiatry Physician
  • Piscataway, NJ
  • NPI 1033207378
  NPD
• Rutgers Health-RWJ Scleroderma Program

  • Allergy & Immunology Physician
  • New Brunswick, NJ
  • NPI 1619059011
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Robert Wood Johnson University Hospital, Inc

  • General Acute Care Hospital
  • New Brunswick, NJ
  • NPI 1346243375

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1689006272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 WOODCREST DR",
            "city": "WOODCLIFF LAKE",
            "state": "NJ",
            "postal_code": "076777629",
            "telephone_number": "845-304-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-4078",
            "fax_number": "551-996-4140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1945 Route 33",
            "address_purpose": "LOCATION",
            "city": "Neptune",
            "state": "NJ",
            "postal_code": "077534859",
            "country_code": "US",
            "telephone_number": "732-775-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "KRISTEN",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-06",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00453200",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00453200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Empowerage Rehabilitation
• Margaret Y Emy, M.D.
• Endoscopic Anesthesia LLC
• Endoscopy Center of Hackensack, LLC
• Elizbeth Maria Engel-Riggi, APN,B
• Ennoble HC FL II LLC
• Ennoble HC FL III, LLC
• Ennoble HC Ky II PLLC
• Ennoble HC Ky III PLLC
• Ennoble HC Ky PLLC

• All providers in Hackensack, NJ
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.

Verify at the official NPI Registry.