Individual provider Active NPI

Aviva Drillick, APN

  • Nurse Practitioner
  • Lakewood, NJ
National Provider Identifier
1760100895
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ01351800 Issued in NJ
Practice address
456 Chestnut St
Lakewood, NJ 08701-6124
Phone
(732) 905-9200
NPI assigned
Aug 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ01351800 NJ Primary

Addresses

Primary practice location

456 Chestnut St
Lakewood, NJ 08701-6124

Mailing address

456 Chestnut St
Lakewood, NJ 08701-6124
Phone (732) 905-9200

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
I20220930000236 NJ Practitioner - Nurse Practitioner 7517343452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology and Skin Surgery PCGroup PAC ID 8921011693, 3 clinicians

Practice addresses (Care Compare)

456 Chestnut St
Suite 201
Lakewood, NJ 08701-6124
Phone (732) 905-9200

Hospital & facility affiliations

  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology & Skin Surgery, PC CurrentSince Sep 8, 2022 Accepting new patients

Locations

886 River Ave
Lakewood, NJ 08701
Phone (201) 367-8280

456 Chestnut St
Ste 201
Lakewood, NJ 08701
Phone (732) 905-9200

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ICICAA

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1760100895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 CHESTNUT ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087016124",
            "telephone_number": "732-905-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 CHESTNUT ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087016124",
            "telephone_number": "732-905-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRILLICK",
        "first_name": "AVIVA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01351800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.