Carol Bacon, APN

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

26NJ00272500 Issued in NJ

Practice address

201 Lyons Ave
Newark Beth Israel Medical Center
Newark, NJ 07112-2027

Phone

(973) 926-7320

Fax

(973) 705-8207

NPI assigned

Apr 12, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barnabas Health Medical Group PCGroup PAC ID 9537316955, 1,027 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Newark Beth Israel Medical Center Hospital, Newark, NJ, CCN 310002

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cbacon230150@epicdirect.rwjbh.org

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.

• Barnabas Health Medical Group PC

  • Specialist
  • Elizabeth, NJ
  • NPI 1841557246
  Medicare reassignment Care Compare group NPD
• Barnabas Health Medical Group PC

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1316772668
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Newark Beth Israel Medical Center Inc

  dba Newark Beth Israel Medical Center

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1215027966
  Care Compare affiliation

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1912340662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "address_2": "NEWARK BETH ISRAEL MEDICAL CENTER",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-7320",
            "fax_number": "973-705-8207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "address_2": "NEWARK BETH ISRAEL MEDICAL CENTER",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-7320",
            "fax_number": "973-705-8207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "CAROL",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-12",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ00272500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shazam Bacchus, APN
• John R. Bach, M.D.
• Ashley Bachkhaz, OD
• Bonita L. Bachl, M.D.
• Back to Health, LLC
• Arthur Badillo, MD
• Pearl Jinju Bae, LAC
• Angie Baez
• Frank Baffige, LPC
• Samy U Baig, R.PH

• Acute Care Nurse Practitioner in Newark, NJ
• Providers in Newark, NJ by specialty
• Acute Care Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.