Individual provider Active NPI

Jessica Barbosa, AGPCNP-BC

  • Nurse Practitioner
  • Secaucus, NJ
National Provider Identifier
1710433701
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00655100 Issued in NJ
Practice address
714 10TH St
Secaucus, NJ 07094-2921
Phone
(201) 865-2050
NPI assigned
Aug 30, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26NJ00655100 NJ
Nurse Practitioner 363L00000X 26NJ00655100 NJ Primary

Addresses

Primary practice location

714 10TH St
Secaucus, NJ 07094-2921

Mailing address

38 Meadowlands Pkwy
Secaucus, NJ 07094-2925
Phone (201) 647-6257

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
I20171227002483 NJ Practitioner - Nurse Practitioner 2365700127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Care of New Jersey PCGroup PAC ID 3072650290, 168 clinicians

Practice addresses (Care Compare)

38 Meadowlands Pkwy
Secaucus, NJ 07094-2925
Phone (201) 479-8610

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
71.59
Promoting interoperability
100
Improvement activities
40
Cost
76.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00655100NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care of New Jersey PC CurrentSince Oct 29, 2017 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Oct 29, 2017 Accepting new patients
Riverside Medical Group Nurse Practitioner Past Accepting new patients
University Hospital Past Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

46 Essex St
Jersey City, NJ 07302
Phone (201) 268-5485

1 Maywood Ave
Maywood, NJ 07607
Phone (201) 464-4772

201 State Rt 17
Fl 1202
Rutherford, NJ 07070
Phone (201) 975-2323

38 Meadowlands Pkwy
Secaucus, NJ 07094
Phone (201) 866-5151

714 10th St
Secaucus, NJ 07094
Phone (201) 863-3346

3403 S Delsea Dr
Vineland, NJ 08360
Phone (856) 293-6974

Interoperability endpoints

  • Direct secure messaging: jbarbosa75552@direct.optum.com

Organizations & group practices 4

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": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1710433701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 MEADOWLANDS PKWY",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942925",
            "telephone_number": "201-647-6257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 10TH ST",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942921",
            "telephone_number": "201-865-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARBOSA",
        "first_name": "JESSICA",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-30",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "26NJ00655100",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00655100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Secaucus, NJ

Sources for this page

Verify at the official NPI Registry.