Individual provider Active NPI

Yohana Revelo-Umana

  • Physician Assistant
  • Brick, NJ
National Provider Identifier
1013648765
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
425 Jack Martin Blvd
Brick, NJ 08724-7732
Phone
(732) 840-2200
Fax
(732) 922-6026
NPI assigned
Jun 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 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 Primary

Addresses

Primary practice location

425 Jack Martin Blvd
Brick, NJ 08724-7732

Mailing address

331 Newman Springs Road
BLDG. 2, Suite 220
Red Bank, NJ 07701
Phone (732) 807-0877

Other practice location 1

478 Brick Blvd
Brick, NJ 08723-6077
Phone (732) 701-4848

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
I20250128004266 NJ Practitioner - Physician Assistant 2062941511 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Surgical & Oncology Associates, P.C CurrentSince Jun 1, 2022 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Dec 1, 2024 Accepting new patients
Atlantic Shore Surgical Associates, PC CurrentSince Jun 1, 2022 Accepting new patients

Locations

478 Brick Blvd
Brick, NJ 08723
Phone (732) 701-4848

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1944 State Route 33
Neptune, NJ 07753
Phone (732) 776-3787

425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

NPI Registry JSON

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1013648765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS ROAD",
            "address_2": "BLDG. 2, SUITE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "07701",
            "telephone_number": "732-807-0877",
            "fax_number": "201-751-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 JACK MARTIN BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247732",
            "telephone_number": "732-840-2200",
            "fax_number": "732-922-6026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "478 Brick Blvd",
            "address_purpose": "LOCATION",
            "city": "Brick",
            "state": "NJ",
            "postal_code": "087236077",
            "country_code": "US",
            "telephone_number": "732-701-4848",
            "fax_number": "732-701-1469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REVELO-UMANA",
        "first_name": "YOHANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-23",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.