Individual provider Active NPI

Paulette Palogruto, FNP-BC

  • Family Nurse Practitioner
  • Sewell, NJ
National Provider Identifier
1699165597
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00459100 Issued in NJ
Practice address
432 Ganttown Rd
Sewell, NJ 08080-1888
Phone
(856) 344-7916
NPI assigned
Jan 29, 2015
Last updated
Dec 11, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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 26NJ00459100 NJ Primary

Addresses

Primary practice location

432 Ganttown Rd
Sewell, NJ 08080-1888

Mailing address

432 Ganttown Rd Ste 202
Sewell, NJ 08080-1896
Phone (856) 344-7916

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
I20161210000023 NJ Practitioner - Nurse Practitioner 5496035347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 513-4124

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00459100NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kennedy Medical Group Practice, P.C. CurrentSince Aug 1, 2019 Accepting new patients
Kennedy Medical Group Practice, P.C. CurrentSince Jun 15, 2021 Accepting new patients
Kennedy Medical Group Practice PC CurrentSince Aug 1, 2019 Accepting new patients
New Jersey Heart, Inc. PastSince Nov 1, 2016 Accepting new patients
Kennedy Medical Group Practice P.C. Past Accepting new patients

Locations

2211 Chapel Ave W
Ste 301
Cherry Hill, NJ 08002
Phone (856) 665-2017

457 Haddonfield Rd
Ste 110
Cherry Hill, NJ 08002
Phone (856) 406-4091

354 Hurffville Crosskeys Rd
Bldg 3
Sewell, NJ 08080
Phone (215) 481-6253

Organizations & group practices 5

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": "1422489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1699165597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 GANTTOWN RD STE 202",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080801896",
            "telephone_number": "856-344-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 GANTTOWN RD",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080801888",
            "telephone_number": "856-344-7916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALOGRUTO",
        "first_name": "PAULETTE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-29",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00459100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

Verify at the official NPI Registry.