Individual provider Active NPI

Roseann Benanti, NP-C

  • Primary Care Nurse Practitioner
  • Englewood, NJ
National Provider Identifier
1780330902
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
26NJ01241000 Issued in NJ
Practice address
420 Grand Ave Ste 101
Englewood, NJ 07631-4141
Phone
(201) 569-7044
Fax
(201) 569-1999
NPI assigned
Feb 25, 2022
Last updated
Feb 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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 26NJ01241000 NJ
Primary Care Nurse Practitioner 363LP2300X 26NJ01241000 NJ Primary

Addresses

Primary practice location

420 Grand Ave Ste 101
Englewood, NJ 07631-4141

Mailing address

81 Parkway
Rochelle Park, NJ 07662-4205
Phone (201) 805-8636

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
I20220621000135 NJ Practitioner - Nurse Practitioner 5092194175 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allied Digestive Health LLCGroup PAC ID 5991027583, 282 clinicians

Practice addresses (Care Compare)

420 Grand Ave
Suite 101
Englewood, NJ 07631-4141
Phone (201) 569-7044

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01241000NJMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Digestive Health, LLC CurrentSince Apr 1, 2022 Accepting new patients
Medical Associates of Englewood, PC CurrentSince Sep 1, 2024 Accepting new patients
Atlantic Coast Gastroenterology Associates Past Accepting new patients

Locations

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

420 Grand Ave
Ste 101
Englewood, NJ 07631
Phone (201) 569-7044

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

1640 Route 88 W
Ste 202
Wall Township, NJ 08724
Phone (732) 370-2220

187 State Route 36
Ste 230
West Long Branch, NJ 07764
Phone (732) 222-3805

Organizations & group practices 3

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": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1780330902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 PARKWAY",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076624205",
            "telephone_number": "201-805-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 GRAND AVE STE 101",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314141",
            "telephone_number": "201-569-7044",
            "fax_number": "201-569-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENANTI",
        "first_name": "ROSEANN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-25",
        "last_updated": "2022-02-25",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ01241000",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ01241000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.