Individual provider Active NPI

Marianne Elizabeth Cavanaugh, APN

  • Critical Care Medicine Clinical Nurse Specialist
  • Wayne, NJ
National Provider Identifier
1821568817
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Clinical Nurse SpecialistTaxonomy code 364SC0200X
License
26NJ00874200 Issued in NJ
Practice address
224 Hamburg Tpke
Wayne, NJ 07470-2168
Phone
(973) 754-2476
NPI assigned
Dec 3, 2018
Last updated
Apr 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 26NJ00874200 NJ
Critical Care Medicine Clinical Nurse Specialist 364SC0200X 26NJ00874200 NJ Primary

Addresses

Primary practice location

224 Hamburg Tpke
Wayne, NJ 07470-2168

Mailing address

224 Hamburg Tpke
Wayne, NJ 07470-2168

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
I20190423000834 NJ Practitioner - Nurse Practitioner 3375885361 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rwjbh Emergency Medicine Associates, LLCGroup PAC ID 0941612840, 826 clinicians

Practice addresses (Care Compare)

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928
Phone (732) 828-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00874200NJMDCritical Care Medicine Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Healthcare, Inc. CurrentSince Apr 8, 2019 Accepting new patients
Internal Medicine of Morris County LLC CurrentSince Mar 1, 2023 Accepting new patients
Rwjbh Emergency Medicine Associates, LLC Acute Care CurrentSince Nov 26, 2023 Accepting new patients
Vital Medical Forces of Dover PC Past Accepting new patients

Locations

25 Pocono Rd
Denville, NJ 07834
Phone (273) 625-6000

225 Williamson St
Elizabeth, NJ 07202
Phone (908) 994-5204

600 River Ave
Lakewood, NJ 08701
Phone (732) 363-1900

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

703 Main St
Bldg 400
Paterson, NJ 07503
Phone (973) 754-2054

703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240

Organizations & group practices 4

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": "1543795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1821568817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702168",
            "telephone_number": "973-754-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "MARIANNE",
        "middle_name": "ELIZABETH",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-03",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ00874200",
            "primary": false
        },
        {
            "code": "364SC0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Critical Care Medicine",
            "state": "NJ",
            "license": "26NJ00874200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.