Individual provider Active NPI

Michael Jin Back, RN, BSN, MSN, FNP-C

  • Family Nurse Practitioner
  • Hackensack, NJ
National Provider Identifier
1023848017
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NR15265100 Issued in NJ
Practice address
170 Prospect Ave Apt 3G
Hackensack, NJ 07601-1857
Phone
(201) 577-8494
NPI assigned
Aug 5, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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 26NR15265100 NJ Primary

Addresses

Primary practice location

170 Prospect Ave Apt 3G
Hackensack, NJ 07601-1857

Mailing address

170 Prospect Ave Apt 3G
Hackensack, NJ 07601-1857
Phone (201) 577-8494

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
I20260326000479 NJ Practitioner - Nurse Practitioner 5395220511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

170 Prospect Ave
Apt 3G
Hackensack, NJ 07601-1820

6 Forest Ave
Suite 202
Paramus, NJ 07652-5241

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
26NR15265100NJMDFamily Nurse Practitioner

Organizations & group practices 1

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": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1023848017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 PROSPECT AVE APT 3G",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011857",
            "telephone_number": "201-577-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 PROSPECT AVE APT 3G",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011857",
            "telephone_number": "201-577-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACK",
        "first_name": "MICHAEL",
        "middle_name": "JIN",
        "credential": "RN, BSN, MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-05",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NR15265100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.