AMANDA EVE IMMERBLUM MS, FNP-BC
NPI 1023860061
Nurse Practitioner - Family in Bloomfield, NJ

Q: What is Amanda Immerblum's NPI number?

The NPI number for Amanda Immerblum is 1023860061. It was assigned to this individual provider in the NPPES registry on April 3, 2024.

Q: What is Amanda Immerblum's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Immerblum was last updated on April 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 03, 2024PECOS Enrolled

256 BROAD ST, BLOOMFIELD, NJ 07003(973) 743-4450 Get Directions Write a Review

NPPES record last updated: April 3, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Amanda Eve Immerblum Ms, Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMANDA EVE IMMERBLUM MS, FNP-BC (NPI 1023860061) is an individual family provider in Bloomfield, New Jersey, licensed in New Jersey (26NJ15046300) and active in the NPI registry since April 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023860061

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameAMANDA EVE IMMERBLUMCredential: MS, FNP-BC

Location Address256 BROAD STBloomfield, NJ 07003-2766

Mailing Address33 Smith LnSomers, NY 10589-1922 · (914) 844-6119

Phone(973) 743-4450

Sole ProprietorNo

Enumeration DateApril 3, 2024

NPPES CertifiedApril 3, 2024

✔ NPI 1023860061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Licenses✔ Licensed in NJ · 26NJ15046300✔ Licensed in NY · 353866

Also ListedRegistered NurseTaxonomy 163W00000X · License 713221 (NY), 26NR24627100 (NJ)

256 BROAD ST, Bloomfield, NJ 07003

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Eve Immerblum Ms, Fnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07003 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$98.09 typical visit price

range $63.84 – $190.92

Typical copayment $24.52 (range $15.96 – $47.73)

Most-billed visit code 99203

Established Patient

$111.57 typical visit price

range $20.97 – $155.92

Typical copayment $27.89 (range $5.24 – $38.98)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MONIQUE VINDAS APN

Nurse Practitioner