Individual provider Active NPI

Mona Marie Aboulnaja, APN-C

  • Primary Care Nurse Practitioner
  • New York, NY
National Provider Identifier
1902225832
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
311725 Issued in NY
Practice address
211 E 80TH St FL 2
New York, NY 10075-0531
Phone
(646) 962-6828
NPI assigned
Apr 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 311725 NY Primary

Addresses

Primary practice location

211 E 80TH St FL 2
New York, NY 10075-0531

Mailing address

211 E 80TH St FL 2
New York, NY 10075-0531
Phone (646) 962-6828

Electronic endpoints 3

TypeEndpointUseAffiliation
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ Health Information Exchange (HIE)
FHIR URL https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
Direct Messaging Address moa4032@direct.nyp.org Direct

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
I20140912000835 NJ Practitioner - Nurse Practitioner 2466671029 Reassigns benefits to 1 organization
I20240709004345 NY Practitioner - Nurse Practitioner 2466671029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Rutgers New Jersey Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

211 E 80TH St
New York, NY 10075-0531
Phone (646) 962-8690

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
311725NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell Current Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Aug 1, 2016 Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 1, 2024 Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 1, 2024 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Aug 1, 2016 Accepting new patients
Cornell University Medical College Past Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

10 1st St
Hackensack, NJ 07601
Phone (201) 342-8130

714 10th St
Secaucus, NJ 07094
Phone (201) 863-3346

3403 S Delsea Dr
Vineland, NJ 08360
Phone (856) 293-6974

211 E 80th St
Fl 2
New York, NY 10075
Phone (646) 962-8690

215 E 85th St
New York, NY 10028
Phone (646) 962-7300

2315 Broadway
Fl 3
New York, NY 10024
Phone (646) 962-2842

211 E 80th St
New York, NY 10075
Phone (212) 746-2158

Interoperability endpoints

  • Direct secure messaging: moa4032@direct.nyp.org

Organizations & group practices 6

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": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1902225832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E 80TH ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750531",
            "telephone_number": "646-962-6828",
            "fax_number": "929-332-7533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E 80TH ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750531",
            "telephone_number": "646-962-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOULNAJA",
        "first_name": "MONA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "APN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-08",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NY",
            "license": "311725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "211 E 80th St Fl 2",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100750531",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "211 E 80th St Fl 2",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100750531",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "moa4032@direct.nyp.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "211 E 80th St Fl 2",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100750531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.