Individual provider Active NPI

Carol Jacqueline Rios, NP

  • Adult Health Nurse Practitioner
  • Hackensack, NJ
National Provider Identifier
1821518101
Registry record updated Jun 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00649700 Issued in NJ
Practice address
92 2ND St Ste 420
Hackensack, NJ 07601-2191
Phone
(551) 996-5811
NPI assigned
Jun 27, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NJ00649700 NJ
Primary Care Nurse Practitioner 363LP2300X 26NJ00649700 NJ
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X 26NJ00649700 NJ Primary

Addresses

Primary practice location

92 2ND St Ste 420
Hackensack, NJ 07601-2191

Mailing address

13-14 Hopper Ave
Fair Lawn, NJ 07410-2211
Phone (201) 952-3249

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
I20230831001451 NJ Practitioner - Nurse Practitioner 0244693752 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00649700NJMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony Medical Services of New Jersey LLC Multi-Specialty Current Accepting new patients
Regional Cancer Care Associates LLC Multi-Specialty CurrentSince Aug 1, 2023 Accepting new patients
Harmony Medical Services of New Jersey LLC Multi-Specialty CurrentSince Aug 18, 2023 Accepting new patients
Regional Cancer Care Associates LLC Multi-Specialty CurrentSince Aug 1, 2023 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

92 2nd St
Ste 420
Hackensack, NJ 07601
Phone (551) 996-5811

92 2nd St
Hackensack, NJ 07601
Phone (551) 996-2210

28 Valley Rd
Montclair, NJ 07042
Phone (908) 451-8519

Organizations & group practices 5

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": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498521600000",
    "number": "1821518101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13-14 HOPPER AVE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102211",
            "telephone_number": "201-952-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 2ND ST STE 420",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012191",
            "telephone_number": "551-996-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIOS",
        "first_name": "CAROL",
        "middle_name": "JACQUELINE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2017-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ00649700",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ00649700",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00649700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.