Individual provider Active NPI

Katherine Elise Lauriello, AGPCNP-BC, MSN

  • Gerontology Nurse Practitioner
  • Jersey City, NJ
National Provider Identifier
1699448274
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
F310236-01 Issued in NY
Practice address
119A Lake St
Jersey City, NJ 07306-3468
Phone
(732) 500-2936
NPI assigned
Jul 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X F310236-01 NY Primary

Addresses

Primary practice location

119A Lake St
Jersey City, NJ 07306-3468

Mailing address

119A Lake St
Jersey City, NJ 07306-3468
Phone (732) 500-2936

Other practice location 1

550 1st Ave
New York, NY 10016-6402
Phone (732) 500-2936

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
I20230223001268 NJ Practitioner - Nurse Practitioner 7911370812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Personal NP Services LLCGroup PAC ID 9335455179, 65 clinicians

Practice addresses (Care Compare)

456 Chestnut St
Suite 102
Lakewood, NJ 08701-6124
Phone (732) 486-7373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F310236-01NYMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal NP Services, LLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

685 River Ave
Unit 3
Lakewood, NJ 08701
Phone (732) 987-3855

456 Chestnut St
Ste 102
Lakewood, NJ 08701
Phone (732) 282-7200

Organizations & group practices 1

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": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1699448274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119A LAKE ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073063468",
            "telephone_number": "732-500-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119A LAKE ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073063468",
            "telephone_number": "732-500-2936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100166402",
            "country_code": "US",
            "telephone_number": "732-500-2936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAURIELLO",
        "first_name": "KATHERINE",
        "middle_name": "ELISE",
        "credential": "AGPCNP-BC, MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NY",
            "license": "F310236-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.