Individual provider Active NPI

Sally A Deeney, NP-C

  • Adult Health Nurse Practitioner
  • Randolph, NJ
National Provider Identifier
1952688079
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00352400 Issued in NJ
Practice address
765 Route 10 E
Suite 201
Randolph, NJ 07869-1925
Phone
(973) 989-0068
Fax
(973) 361-8955
NPI assigned
Nov 3, 2011
Last updated
Nov 3, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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 26NJ00352400 NJ Primary

Addresses

Primary practice location

765 Route 10 E
Suite 201
Randolph, NJ 07869-1925

Mailing address

765 Route 10 E
Suite 201
Randolph, NJ 07869-1925
Phone (973) 989-0068

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
I20111202000630 NJ Practitioner - Nurse Practitioner 2062687015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Id Care LLCGroup PAC ID 7719959998, 119 clinicians

Practice addresses (Care Compare)

105 Raider Blvd
Suite 101
Hillsborough, NJ 08844-1528
Phone (908) 281-0221

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.51 of 100Reported as group
Quality
49.12
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Id Care LLC CurrentSince Dec 15, 2011 Accepting new patients

Locations

8 Saddle Rd
Ste 203
Cedar Knolls, NJ 07927
Phone (973) 993-5950

400 W Blackwell St
Dover, NJ 07801
Phone (973) 537-3818

105 Raider Blvd
Ste 101
Hillsborough, NJ 08844
Phone (908) 281-0221

765 Route 10 E
Ste 201
Randolph, NJ 07869
Phone (973) 479-1128

Interoperability endpoints

  • Direct secure messaging: sdeeney88013@direct.ahsys.org

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320278400000",
    "number": "1952688079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 ROUTE 10 E",
            "address_2": "SUITE 201",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078691925",
            "telephone_number": "973-989-0068",
            "fax_number": "973-361-8955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 ROUTE 10 E",
            "address_2": "SUITE 201",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078691925",
            "telephone_number": "973-989-0068",
            "fax_number": "973-361-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEENEY",
        "first_name": "SALLY",
        "middle_name": "A",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2011-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00352400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, NJ

Sources for this page

Verify at the official NPI Registry.