Individual provider Active NPI

Annamma Thomas, APN

  • Gerontology Nurse Practitioner
  • Livingston, NJ
National Provider Identifier
1740757590
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NJ00871700 Issued in NJ
Practice address
94 Old Short Hills Road
Livingston, NJ 07039
Phone
(973) 322-5000
NPI assigned
Oct 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ00871700 NJ Primary
Nurse Practitioner 363L00000X 26NJ00871700 NJ

Addresses

Primary practice location

94 Old Short Hills Road
Livingston, NJ 07039

Mailing address

26 Brookside PL
Livingston, NJ 07039-4034
Phone (973) 651-0610

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
I20181210002198 NJ Practitioner - Nurse Practitioner 9739423252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Emergency Medicine Associates, LLCGroup PAC ID 0941612840, 826 clinicians

Practice addresses (Care Compare)

201 Lyons Ave
Newark, NJ 07112-2027
Phone (973) 926-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.07 of 100Reported as group
Quality
76.5
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Emergency Medicine Associates, LLC Nurse Practitioner CurrentSince Nov 30, 2020 Accepting new patients

Locations

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

600 River Ave
Lakewood, NJ 08701
Phone (732) 363-1900

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1740757590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 BROOKSIDE PL",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394034",
            "telephone_number": "973-651-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 OLD SHORT HILLS ROAD",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "07039",
            "telephone_number": "973-322-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "ANNAMMA",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00871700",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00871700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.