ETIENNE KENFACK (APN) – Primary Care Nurse Practitioner, NPI 1033677679
Primary Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,515 NURSE PRACTITIONER in NJ
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Provider Addresses for ETIENNE KENFACK (APN)
191, Palisade Avenue, Jersey City, Hudson County, New Jersey, 07306, United States
JERSEY CITY, NJ 073061112
Phone: (201) 656-4324
Fax: (201) 656-4019
Type: Location
42, Chester Avenue, Irvington, Essex County, New Jersey, 07111, United States
IRVINGTON, NJ 071113142
Phone: (862) 224-0668
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 46 Open Payments records for all available years, with a total value of $778.
Total Amount is formed as General ($778) + Research ($0) + Ownership ($0) = $778.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Salix Pharmaceuticals, a division of Bausch Health US, LLC ($320).
Total Amount
$778
General + Research + Ownership
Payments
46
Total payment records
General Amount
$778
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-04-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190404001838 | I | Nurse Practitioner | NJ | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 07306)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | NY | |
| Diagnostic Radiology | NJ | |
| Diagnostic Radiology | NJ | |
| C H I R O P R A C T I C | NJ | |
| Diagnostic Radiology | NJ | |
| Physical Medicine And Rehabilitation | NJ | |
| Physical Therapist In Private Practice | CA | |
| Diagnostic Radiology | FL | |
| Physical Medicine And Rehabilitation, Family Practice, Geriatric Medicine, Interventional Pain Management, Interventional Radiology | NJ | |
| - | NJ |
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