Individual provider Active NPI

Teresa Vaccaro, NP

  • Family Nurse Practitioner
  • Lakewood, NJ
National Provider Identifier
1902840143
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00095600 Issued in NJ
Practice address
Kimball Medical Center
600 River Avenue
Lakewood, NJ 08701
Phone
(732) 363-1900
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00095600 NJ Primary

Addresses

Primary practice location

Kimball Medical Center
600 River Avenue
Lakewood, NJ 08701

Mailing address

PO Box 717
Livingston, NJ 07039-0717
Phone (973) 740-0607

Other practice location 1

300 2nd Ave
Long Branch, NJ 07740-6303
Phone (732) 222-5200

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
I20051021000749 NJ Practitioner - Nurse Practitioner 1951327022 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.07 of 100Reported as group
Quality
76.5
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00095600NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Observation Associates LLC Nurse Practitioner CurrentSince Nov 30, 2020 Accepting new patients
Rwjbh Emergency Medicine Associates, LLC Nurse Practitioner CurrentSince Nov 30, 2020 Accepting new patients
Emergency Medical Associates of New Jersey PA Past Accepting new patients
Emergency Medical Associates of New Jersey PA PastSince May 10, 2020 Accepting new patients

Locations

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

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

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

Interoperability endpoints

  • Direct secure messaging: tvaccaro48313@epicdirect.rwjbh.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1902840143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 717",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070390717",
            "telephone_number": "973-740-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KIMBALL MEDICAL CENTER",
            "address_2": "600 RIVER AVENUE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "08701",
            "telephone_number": "732-363-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Long Branch",
            "state": "NJ",
            "postal_code": "077406303",
            "country_code": "US",
            "telephone_number": "732-222-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VACCARO",
        "first_name": "TERESA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00095600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.