Individual provider Active NPI

Kimberly Atienza, M.D.

  • Internal Medicine Physician
  • Neptune, NJ
National Provider Identifier
1881653848
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA079626 Issued in NJ
Practice address
1812 Corlies Ave
Neptune, NJ 07753-4802
Phone
(732) 807-3834
Fax
(732) 807-3835
NPI assigned
Mar 20, 2006
Last updated
Feb 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA079626 NJ Primary

Addresses

Primary practice location

1812 Corlies Ave
Neptune, NJ 07753-4802

Mailing address

1812 Corlies Ave
Neptune, NJ 07753-4802
Phone (732) 807-3834

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050829000479 NJ Practitioner - Internal MedicinePractitioner - Geriatric Medicine 8426088212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neptune Adult Medicine LLCGroup PAC ID 6002087053, 2 clinicians

Practice addresses (Care Compare)

1812 Corlies Ave
Neptune, NJ 07753-4802
Phone (734) 807-3834

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA079626NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neptune Pediatrics LLC PastSince Mar 27, 2017 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kimberly.atienza.1@11042.direct.athenahealth.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 3

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1881653848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 CORLIES AVE",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534802",
            "telephone_number": "732-807-3834",
            "fax_number": "732-807-3835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 CORLIES AVE",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534802",
            "telephone_number": "732-807-3834",
            "fax_number": "732-807-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATIENZA",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-20",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA079626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

Verify at the official NPI Registry.