Individual provider Active NPI

Adriana Ackerman, ANCC

  • Adult Health Nurse Practitioner
  • Somerset, NJ
National Provider Identifier
1740348580
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2006010102-21 Issued in NJ
Practice address
75 Veronica Ave
Suite 204
Somerset, NJ 08873-5002
Phone
(732) 828-0002
Fax
(732) 828-7070
NPI assigned
Dec 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2006010102-21 NJ Primary

Addresses

Primary practice location

75 Veronica Ave
Suite 204
Somerset, NJ 08873-5002

Mailing address

75 Veronica Ave
Suite 204
Somerset, NJ 08873-5002
Phone (732) 828-0002

Other identifiers 1

IdentifierTypeStateIssuer
2006010102-21OtherNJAPN CERTIFICATE

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
I20070424000681 NJ Practitioner - Nurse Practitioner 8820193543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Jersey Internal Medicine Associates,PAGroup PAC ID 9830171131, 12 clinicians

Practice addresses (Care Compare)

111 Union Valley Rd
Suite 203
Monroe Township, NJ 08831-6000
Phone (609) 655-2255

75 Veronica Ave
Suite 204
Somerset, NJ 08873-5002
Phone (732) 828-0002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006010102-21NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Jersey Internal Medicine Associates,PA CurrentSince Dec 1, 2006 Accepting new patients
Central Jersey Internal Medicine Associates P a Past Accepting new patients

Locations

111 Union Valley Rd
Ste 203
Monroe Township, NJ 08831
Phone (609) 655-2255

75 Veronica Ave
Ste 204
Somerset, NJ 08873
Phone (732) 828-0002

Interoperability endpoints

  • Direct secure messaging: adriana.ackerman.1@19815.direct.athenahealth.com

Organizations & group practices 2

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740348580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 VERONICA AVE",
            "address_2": "SUITE 204",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088735002",
            "telephone_number": "732-828-0002",
            "fax_number": "732-828-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 VERONICA AVE",
            "address_2": "SUITE 204",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088735002",
            "telephone_number": "732-828-0002",
            "fax_number": "732-828-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "ADRIANA",
        "credential": "ANCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "2006010102-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN CERTIFICATE",
            "identifier": "2006010102-21",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

Verify at the official NPI Registry.