Susan Marie Popolo Becker, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NN105310 Issued in NJ

Practice address

1 Cedar Crest Village Dr
Pompton Plains, NJ 07444-2100

Phone

(973) 831-3540

Fax

(973) 831-3503

NPI assigned

Nov 1, 2006

Last updated

Jan 13, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• New Jersey Veterans Memorial Home Menlo Park

  • Skilled Nursing Facility
  • Edison, NJ
  • NPI 1144557802
  NPD (past)
• New Jersey Veterans Memorial Home Menlo Park

  • Skilled Nursing Facility
  • Edison, NJ
  • NPI 1194715409
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1760569982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 MAIDEN CHOICE LN",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212283679",
            "telephone_number": "410-402-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CEDAR CREST VILLAGE DR",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074442100",
            "telephone_number": "973-831-3540",
            "fax_number": "973-831-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPOLO BECKER",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "NN105310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0203335",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "83-14608",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BCBS OF NJ",
            "identifier": "52-2114204-0",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "522114204001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Plains Cardiopulmonary Associates
• Gretchen Ann Poage, MA, CCC-SLP
• Pompton Family Dental Services, PA
• Pompton Plains Pathologists P a
• Ernest John Pomroy III, MSPT
• Adrienne Margaret Popovich, LCSW, MSW
• Steven Darren Potter, M.D.
• Gwen A Pra, MHA, OTR/L
• Pro Vision Physical Therapy
• Procare Medical Transportation Corp

• Nurse Practitioner in Pompton Plains, NJ
• Providers in Pompton Plains, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.