Individual provider Active NPI

Kathleen Vander Ploeg, APN

  • Adult Health Nurse Practitioner
  • Teaneck, NJ
National Provider Identifier
1922367150
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00376000 Issued in NJ
Practice address
718 Teaneck Rd
Teaneck, NJ 07666-4245
Phone
(201) 833-3000
NPI assigned
May 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00376000 NJ Primary

Addresses

Primary practice location

718 Teaneck Rd
Teaneck, NJ 07666-4245

Mailing address

718 Teaneck Rd
Teaneck, NJ 07666-4245
Phone (201) 833-3000

Other names 1

  • Kathleen Redfearn Former name

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
I20131211000557 NJ Practitioner - Nurse Practitioner 8921235375 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00376000NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Aug 8, 2016 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Aug 8, 2016 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

20 Prospect Ave
Ste 516
Hackensack, NJ 07601
Phone (201) 488-8989

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1922367150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 TEANECK RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664245",
            "telephone_number": "201-833-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 TEANECK RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664245",
            "telephone_number": "201-833-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER PLOEG",
        "first_name": "KATHLEEN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-08",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00376000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "REDFEARN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.