Agnieszka Dziubak

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

26NJ15213900 Issued in NJ

Practice address

325 Stevens Way
Freehold, NJ 07728-5359

Phone

(908) 967-9039

NPI assigned

Dec 2, 2024

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlas Senior Care LLCGroup PAC ID 4880198613, 11 clinicians

Atlas Medical Care,LLCGroup PAC ID 5597926659, 9 clinicians

Rgohel LLCGroup PAC ID 0941554547, 5 clinicians

Rekha Gohel MD LLCGroup PAC ID 1153602578, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centrastate Medical Center Hospital, Freehold, NJ, CCN 310111

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Atlas Medical Care,LLC

  • Internal Medicine Physician
  • Freehold, NJ
  • NPI 1689951592
  Medicare reassignment Care Compare group NPD
• Atlas Senior Care LLC

  • Primary Care Clinic/Center
  • Freehold, NJ
  • NPI 1144112772
  Medicare reassignment Care Compare group NPD
• Rekha Gohel MD LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Manalapan, NJ
  • NPI 1912352642
  Medicare reassignment Care Compare group NPD
• Rgohel LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Freehold, NJ
  • NPI 1902388960
  Medicare reassignment Care Compare group NPD
• Kane Wound Care LLC

  • Internal Medicine Physician
  • Princeton, NJ
  • NPI 1275869802
  Medicare reassignment NPD

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

• Centrastate Medical Center, Inc

  • General Acute Care Hospital
  • Freehold, NJ
  • NPI 1295718450
  Care Compare affiliation

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

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1962228429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 STEVENS WAY",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077285359",
            "telephone_number": "908-967-9039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 STEVENS WAY",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077285359",
            "telephone_number": "908-967-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIUBAK",
        "first_name": "AGNIESZKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ15213900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dungarvin New Jersey, LLC-Helen
• Rosemary Durnan, M.D.
• Patricia Durso, CRNA
• Dylhar LLC
• Dynamic Physical Therapy of New Jersey P.a.
• E&M Communications LLC
• Ear Nose & Throat of Freehold LLC
• East Freehold Medical Group L.L.C.
• Glenn Easton, CO,BOCPO,LPO
• Edward Schechterman DMD PA

• Gerontology Nurse Practitioner in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Gerontology Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.