Individual provider Active NPI

Caitlin Provost Conlon

  • Nurse Practitioner
  • Millburn, NJ
National Provider Identifier
1003572579
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ15336900 Issued in NJ
Practice address
33 Bleeker St
Millburn, NJ 07041-1459
Phone
(973) 330-0810
NPI assigned
Nov 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ15336900 NJ Primary
Family Nurse Practitioner 363LF0000X 26NR26902600 NJ

Addresses

Primary practice location

33 Bleeker St
Millburn, NJ 07041-1459

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NJ2 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
I20220127000623 CA Practitioner - Nurse Practitioner 0143612044 Reassigns benefits to 1 organization
I20250916000756 NJ Practitioner - Nurse Practitioner 0143612044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Hospital & facility affiliations

  • Atlantic Visiting Nurse Home health agency, Morristown, NJ, CCN 317054

Merit-based Incentive Payment System (MIPS)

Final score
80.57 of 100Reported as group
Quality
62.42
Promoting interoperability
76
Improvement activities
40
Cost
76.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ15336900NJMDNurse Practitioner
26NR26902600NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Sep 29, 2025 Accepting new patients
Summit Medical Group PA CurrentSince Sep 29, 2025 Accepting new patients
Lakeside Medical Organization, a Medical Group Inc. CurrentSince Dec 13, 2021 Accepting new patients
Lakeside Medical Associates, a Medical Group, Inc. Nurse Practitioner Past Accepting new patients

Locations

191 S Buena Vista St
Ste 200
Burbank, CA 91505
Phone (818) 887-2671

8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000

1500 W West Covina Pkwy
West Covina, CA 91790
Phone (626) 430-9991

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

150 Floral Ave
New Providence, NJ 07974
Phone (908) 588-3890

Interoperability endpoints

  • Direct secure messaging: caitlin.conlon.1@2983.direct.athenahealth.com
  • Direct secure messaging: caitlyn.conlon.p1@direct.lakeside.nextgenshare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1003572579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 BLEEKER ST",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411459",
            "telephone_number": "973-330-0810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLON",
        "first_name": "CAITLIN",
        "middle_name": "PROVOST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ15336900",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NR26902600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millburn, NJ

Sources for this page

Verify at the official NPI Registry.