Individual provider Active NPI

Kathryn Bagnardi, PA-C

  • Physician Assistant
  • New Brunswick, NJ
National Provider Identifier
1003557422
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00746100 Issued in NJ
Practice address
10 Plum St FL 5
New Brunswick, NJ 08901-2066
Phone
(732) 235-5530
NPI assigned
Apr 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00746100 NJ Primary

Addresses

Primary practice location

10 Plum St FL 5
New Brunswick, NJ 08901-2066

Mailing address

200 Tilton Rd Ste 5
Northfield, NJ 08225-1270
Phone (609) 400-3910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230302002209 NJ Practitioner - Physician Assistant 5294108742 Reassigns benefits to 2 organizations
I20250728000845 PA Practitioner - Physician Assistant 5294108742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schweiger Dermatology PCGroup PAC ID 0143442806, 180 clinicians

Practice addresses (Care Compare)

2 Hudson PL
Hoboken, NJ 07030-5594
Phone (212) 283-3000

200 Tilton Rd
Suite 5
Northfield, NJ 08225-1270
Phone (212) 283-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Jan 1, 2023 Accepting new patients
Rutgers Health-RWJ Neurosurgery Faculty CurrentSince Jan 1, 2023 Accepting new patients

Locations

10 Plum St
Fl 5
New Brunswick, NJ 08901
Phone (732) 235-5530

125 Paterson St
Ste 4100
New Brunswick, NJ 08901
Phone (732) 235-7756

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1003557422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TILTON RD STE 5",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082251270",
            "telephone_number": "609-400-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PLUM ST FL 5",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089012066",
            "telephone_number": "732-235-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGNARDI",
        "first_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-07",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00746100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.