Kristina Marie Dauernheim, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00582200 Issued in NJ

Practice address

19 Davis Ave
4TH Floor Hope Tower
Neptune, NJ 07753

Phone

(732) 974-0003

NPI assigned

Jun 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hackensack Meridian Health Medical Group - Specialty Care PC

  dba HMHMG Specialty Care

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249
  Medicare reassignment Care Compare group NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  dba HMMG New Jersey Oral & Maxillofacial Surgery

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD
• Hackensack Meridian Health Medical Group - Complex Care PC

  dba HMHMG Complex Care

  • Internal Medicine Physician
  • Red Bank, NJ
  • NPI 1154379626

  Surgery

  NPD (past)

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

• HMH Hospitals Corporation

  dba HMH Behavioral Health Home

  • Clinic/Center
  • Neptune, NJ
  • NPI 1053880286

  Hospital

  Care Compare affiliation
• HMH Hospitals Corporation

  dba Jersey Shore University Medical Center

  • General Acute Care Hospital
  • Neptune, NJ
  • NPI 1790297547
  Care Compare affiliation
• HMH Hospitals Corporation

  dba Hackensack Meridian Diagnostic Laboratory

  • Clinical Medical Laboratory
  • Neptune City, NJ
  • NPI 1962128496

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1592611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1942826458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 DAVIS AVE",
            "address_2": "4TH FLOOR HOPE TOWER",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 DAVIS AVE",
            "address_2": "4TH FLOOR HOPE TOWER",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-974-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUERNHEIM",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-20",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MP00582200",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00582200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austen M Damerau
• Sowmya Dandu, MD
• Katie Dang, DO
• Muhammad Danial, DO
• Shabbar F Danish, MD
• Chloe Elizabeth Daum
• Gina L. Davis-Lane, MSW, LCADC, CCS
• Charlene Davis, NP
• Ruth A Davis, APNC
• Maria Agnes C Dawis, M.D.

• Surgical Physician Assistant in Neptune, NJ
• Providers in Neptune, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.