Individual provider Active NPI

Paola Caeiro Raguseo, R.N., APN-BC

  • Adult Health Nurse Practitioner
  • Clark, NJ
National Provider Identifier
1770743866
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00159800 Issued in NJ
Practice address
152 Central Ave
Clark, NJ 07066-1115
Phone
(732) 382-9700
Fax
(732) 382-9707
NPI assigned
Jun 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

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 26NJ00159800 NJ Primary

Addresses

Primary practice location

152 Central Ave
Clark, NJ 07066-1115

Mailing address

152 Central Ave
Clark, NJ 07066-1115
Phone (732) 382-9700

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
I20110125001084 NJ Practitioner - Nurse Practitioner 9537348396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

901 W Main St
Freehold, NJ 07728-2537

902 W Main St
Atlantic Medical Group
Freehold, NJ 07728-2508
Phone (732) 431-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Jun 22, 2021 Accepting new patients
Kenneth Faistl, MD,PA CurrentSince Sep 26, 2016 Accepting new patients

Locations

281 State Route 34
Ste 813
Colts Neck, NJ 07722
Phone (732) 431-2620

17 Broad St
Freehold, NJ 07728
Phone (732) 462-9622

901 W Main St
Ste 305B
Freehold, NJ 07728
Phone (732) 462-0100

901 W Main St
Ste 260A
Freehold, NJ 07728
Phone (732) 462-0100

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

Interoperability endpoints

  • Direct secure messaging: paola.raguseo.p1@direct.fpcs.nextgenshare.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.

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": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1770743866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 CENTRAL AVE",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661115",
            "telephone_number": "732-382-9700",
            "fax_number": "732-382-9707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 CENTRAL AVE",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070661115",
            "telephone_number": "732-382-9700",
            "fax_number": "732-382-9707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGUSEO",
        "first_name": "PAOLA",
        "middle_name": "CAEIRO",
        "name_prefix": "Miss",
        "credential": "R.N., APN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00159800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clark, NJ

Sources for this page

Verify at the official NPI Registry.