HENRIETA RICCOBONO DNP
NPI 1174296511
Nurse Practitioner - Acute Care in Passaic, NJ

Q: What is Henrieta Riccobono's NPI number?

The NPI number for Henrieta Riccobono is 1174296511. It was assigned to this individual provider in the NPPES registry on July 30, 2021.

Q: What is Henrieta Riccobono's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Active since July 30, 2021PECOS Enrolled

350 BOULEVARD, PASSAIC, NJ 07055(973) 365-4387 Get Directions Write a Review

NPPES record last updated: July 30, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Henrieta Riccobono Dnp NPPES

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

HENRIETA RICCOBONO DNP (NPI 1174296511) is an individual acute care provider in Passaic, New Jersey, licensed in New Jersey (26NJ01183100) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1174296511

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameHENRIETA RICCOBONOCredential: DNP

Location Address350 BOULEVARDPassaic, NJ 07055-2840

Mailing Address350 BoulevardPassaic, NJ 07055-2840 · (973) 365-4387

Phone(973) 365-4387

Sole ProprietorYes

Medical School CMSOtherGraduated 2021

Enumeration DateJuly 30, 2021

NPPES CertifiedJuly 8, 2021

✔ NPI 1174296511 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in NJ · 26NJ01183100

350 BOULEVARD, Passaic, NJ 07055

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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)

Henrieta Riccobono Dnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID5496144628

PECOS Enrollment IDI20251013001038

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 07055 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.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) A4221

DME-Other DME · category DE017N

1 supplier11 claims11 services$18.41 avg. paid by Medicare

Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) A4222

DME-Medical/Surgical Supplies · category DA000N

1 supplier11 claims40 services$35.86 avg. paid by Medicare

Injection, milrinone lactate, 5 mg J2260

Treatment-Injections and Infusions (nononcologic) · category RI026N

1 supplier11 claims400 services$1.28 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

ASHWIN NELLIPARAMBIL JITHEESH

Student in an Organized Health Care Education/Training Program

350 BOULEVARD, ST. MARY'S HOSPITAL MEMORIAL BUILDING, ROOM 416
PASSAIC, NJ 07055

Passaic County (404) 503-3936

BAY RADIATION ONCOLOGY,P.L.L.C

Radiology (Therapeutic Radiology)