Krystal Lynn Goula, APN
Individual provider Active NPI Family Nurse Practitioner · Pomona, NJ
NPI 1699484279 · NPPES record last updated Oct 15, 2024
Key facts
- NPI
- 1699484279
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 26NJ14911600 (NJ)
- Practice address
- 65 W Jimmie Leeds Rd
Pomona, NJ 08240-9102 - Phone
- (609) 652-1000
- NPI assigned
- Nov 22, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Atlanticare Physician Group PA
Practice addresses (Care Compare)
2500 English Creek Ave
BLDG 200 Suite 223
Egg Harbor Township, NJ 08234-5598
Phone (609) 407-2277
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.34 of 100
- Quality
- 79.77
- Promoting interoperability
- 100
- Improvement activities
- 40
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 |
|---|---|---|---|---|
| I20231025001783 | NJ | Practitioner - Nurse Practitioner | 4486000536 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NR18214800 | NJ | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlanticare Physician Group PA | Current |
Accepting new patients | |
| Atlanticare Physician Group, PA | Current |
Accepting new patients | |
| Atlanticare Physician Group | Past | Accepting new patients |
Locations
2500 English Creek Ave
Ste 200
Egg Harbor Township, NJ 08234
Phone (609) 677-6000
2500 English Creek Ave
Ste 223
Egg Harbor Twp, NJ 08234
Phone (609) 407-2277
459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815
65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 26NR18214800 | NJ | |
| Family Nurse Practitioner | 363LF0000X | 26NJ14911600 | NJ | Yes |
Addresses
Primary practice location
65 W Jimmie Leeds Rd
Pomona, NJ 08240-9102
Mailing address
65 W Jimmie Leeds Rd
Pomona, NJ 08240-9102
Phone (609) 652-1000
Other providers in Pomona, NJ
- Patricia Giegerich
- Gioia Cardiac and Endovascular Interventional Specialty LLC
- Marissa Glaze
- Craig Steven Glick
- Joyce Glick
- Antonio Grafilo
- Denise Graybill
- Stephanie Anne Grayson
- Stephen Gregory
- Yi Gu
All providers in Pomona, NJ · Family 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 Oct 15, 2024. 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.