Individual provider Active NPI

Maria Nunzia Petruzzelli, WHNP-BC

  • Women's Health Nurse Practitioner
  • River Edge, NJ
National Provider Identifier
1942727003
Registry record updated Aug 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
26NJ00707000 Issued in NJ
Practice address
130 Kinderkamack Rd Ste 300
River Edge, NJ 07661-1931
Phone
(201) 489-2727
Fax
(201) 489-5040
NPI assigned
Aug 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 26NJ00707000 NJ Primary

Addresses

Primary practice location

130 Kinderkamack Rd Ste 300
River Edge, NJ 07661-1931

Mailing address

130 Kinderkamack Rd
River Edge, NJ 07661-1939
Phone (201) 489-2727

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
I20171116001097 NJ Practitioner - Nurse Practitioner 7416213996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-5045

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ00707000NJMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Sep 24, 2017 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Sep 24, 2017 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients

Locations

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

120 River St
Hackensack, NJ 07601
Phone (551) 996-1888

360 Essex St
Ste 303
Hackensack, NJ 07601
Phone (551) 996-3091

130 Kinderkamack Rd
River Edge, NJ 07661
Phone (201) 288-9191

130 Kinderkamack Rd
Ste 300
River Edge, NJ 07661
Phone (201) 489-2727

Interoperability endpoints

  • Direct secure messaging: maria.petruzzelli@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503964800000",
    "number": "1942727003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 KINDERKAMACK RD",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076611939",
            "telephone_number": "201-489-2727",
            "fax_number": "201-489-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 KINDERKAMACK RD STE 300",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076611931",
            "telephone_number": "201-489-2727",
            "fax_number": "201-489-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUZZELLI",
        "first_name": "MARIA",
        "middle_name": "NUNZIA",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-29",
        "last_updated": "2017-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NJ",
            "license": "26NJ00707000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in River Edge, NJ

Sources for this page

Verify at the official NPI Registry.