Maryna Prodan, RN, MSN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00592200 Issued in NJ

Practice address

1395 Clinton Ave
Irvington, NJ 07111-1412

Phone

(973) 399-1002

Fax

(973) 375-4837

NPI assigned

Nov 3, 2015

Last updated

Nov 3, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Visiting Nurse Association of Central Jersey, Inc.

  • Geriatric Medicine (Family Medicine) Physician
  • Holmdel, NJ
  • NPI 1336195791
  Medicare reassignment NPD

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

{
    "created_epoch": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1710350426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 CLINTON AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111412",
            "telephone_number": "973-399-1002",
            "fax_number": "973-375-4837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 CLINTON AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111412",
            "telephone_number": "973-399-1002",
            "fax_number": "973-375-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRODAN",
        "first_name": "MARYNA",
        "credential": "RN, MSN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-03",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00592200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premium Residential Services
• Preshman LLC
• Prestige Care LLC
• Priceless Joy
• Prime Pediatrics PC
• Professional OB GYN & Infertility Center of Irvington P a
• Promedical Equipment Sup LLC
• Protecta Home Care Agency LLC
• PSP Transportation LLC
• Purpleblue Behavioral Health (Same)

• Family Nurse Practitioner in Irvington, NJ
• Providers in Irvington, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.