Agnieszka Dziubak, in Freehold, NJ - Medicare Nurse Practitioner

Agnieszka Dziubak, is a medicare enrolled "Nurse Practitioner - Gerontology" in Freehold, New Jersey. Her current practice location is 325 Stevens Way, Freehold, New Jersey. You can reach out to her office (for appointments etc.) via phone at (908) 967-9039.

Agnieszka Dziubak is licensed to practice in New Jersey (license number 26NJ15213900) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1962228429.

Contact Information

	Agnieszka Dziubak,
	325 Stevens Way, Freehold, NJ 07728-5359
	(908) 967-9039
	Not Available

Map and Direction

Provider's Profile

Full Name	Agnieszka Dziubak
Gender	Female
Speciality	Nurse Practitioner - Gerontology
Location	325 Stevens Way, Freehold, New Jersey
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1962228429
Provider Enumeration Date: 12/02/2024
Last Update Date: 12/02/2024

Medicare PECOS Information:

PECOS PAC ID: 5193255636
Enrollment ID: I20250212002722

Medical Identifiers

Medical identifiers for Agnieszka Dziubak such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1962228429	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LG0600X	Nurse Practitioner - Gerontology	26NJ15213900 (New Jersey)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Agnieszka Dziubak allows following entities to bill medicare on her behalf.

Entity Name	Kane Wound Care Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1275869802 PECOS PAC ID: 2567591274 Enrollment ID: O20100518000684

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Agnieszka Dziubak is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Agnieszka Dziubak, 325 Stevens Way, Freehold, NJ 07728-5359 Ph: (908) 967-9039	Agnieszka Dziubak, 325 Stevens Way, Freehold, NJ 07728-5359 Ph: (908) 967-9039

Reviews and Comments

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Agnieszka Dziubak, - Medicare Nurse Practitioner in Freehold, NJ