Individual provider Active NPI

Charmane Calilap-Bernardo, PNPC-PC

  • Pediatric Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1801112552
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
26NJ00157700 Issued in NJ
Practice address
741 Broadway
Newark, NJ 07104-4309
Phone
(973) 483-1300
NPI assigned
Apr 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 26NJ00157700 NJ Primary

Addresses

Primary practice location

741 Broadway
Newark, NJ 07104-4309

Mailing address

741 Broadway
Newark, NJ 07104-4309

Other names 1

  • Charmane B Calilap Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120125000273 NJ Practitioner - Nurse Practitioner 7719154137 Reassigns benefits to 1 organization
I20200713001941 NY Practitioner - Nurse Practitioner 7719154137 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
382232NYMDRegistered Nurse

Practice roles (2 of 6)

OrganizationSpecialtyStatusNew patients
Newark Community Health Centers, Inc CurrentSince Dec 27, 2011 Accepting new patients
Newark Community Health Centers, Inc. CurrentSince Dec 27, 2011 Accepting new patients

Locations

741 Broadway
Newark, NJ 07104
Phone (973) 483-1300

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: ccalilapbernardo60809@northwell.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/HBFIAA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1801112552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 BROADWAY",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071044309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 BROADWAY",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071044309",
            "telephone_number": "973-483-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALILAP-BERNARDO",
        "first_name": "CHARMANE",
        "credential": "PNPC-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NJ00157700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARMANE",
            "last_name": "CALILAP",
            "middle_name": "B",
            "credential": "PNPC-PC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.