Individual provider Active NPI

Susan Mugalu, ANP

  • Family Nurse Practitioner
  • Paterson, NJ
National Provider Identifier
1003597857
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ14847600 Issued in NJ
Practice address
703 Main St
Paterson, NJ 07503-2621
Phone
(973) 754-0000
NPI assigned
Jul 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ14847600 NJ Primary

Addresses

Primary practice location

703 Main St
Paterson, NJ 07503-2621

Mailing address

7 Gates PL
Wayne, NJ 07470-3217
Phone (973) 883-5889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240318000790 NJ Practitioner - Nurse Practitioner 8921445628 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical Group PCGroup PAC ID 8628470325, 217 clinicians

Practice addresses (Care Compare)

220 Hamburg Tpke
Suite 16
Wayne, NJ 07470-2132
Phone (973) 389-6090

Hospital & facility affiliations

  • St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center at Fair Lawn, LLC CurrentSince Jan 28, 2024 Accepting new patients
St Josephs Medical Group PC CurrentSince Nov 25, 2024 Accepting new patients

Locations

2328 10th Ave N
Ste 302
Lake Worth Beach, FL 33461
Phone (561) 318-4411

2328 10th Ave N
Ste 300
Lake Worth Beach, FL 33461
Phone (561) 318-4476

16-01 Broadway
Fair Lawn, NJ 07410
Phone (201) 389-5326

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

225 Minnisink Rd
Fl 3
Totowa, NJ 07512
Phone (862) 657-3150

220 Hamburg Tpke
Ste 16
Wayne, NJ 07470
Phone (973) 389-6090

220 Hamburg Tpke
Ste 203
Wayne, NJ 07470

Organizations & group practices 2

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": "1690243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1003597857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 GATES PL",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703217",
            "telephone_number": "973-883-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUGALU",
        "first_name": "SUSAN",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ14847600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.