Individual provider Active NPI

Monica Rosales Santillan

  • Dermatology Physician
  • West New York, NJ
National Provider Identifier
1033606249
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25MA12382700 Issued in NJ
Practice address
5809 Madison St
West New York, NJ 07093-1005
Phone
(201) 861-4226
NPI assigned
Apr 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X 25MA12382700 NJ Primary

Addresses

Primary practice location

5809 Madison St
West New York, NJ 07093-1005

Mailing address

5809 Madison St
West New York, NJ 07093-1005

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241025000352 NJ Practitioner - Dermatology 7416480751 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Medical School at Houston, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clark Dermatology LLCGroup PAC ID 5395703573, 46 clinicians

Practice addresses (Care Compare)

5809 Madison St
West New York, NJ 07093-1005
Phone (201) 861-4226

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions45
Skin biopsy55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA12382700NJMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clark Dermatology LLC Dermatology CurrentSince Apr 1, 2025 Accepting new patients
Kinnelon Dermatology Associates PC Dermatology CurrentSince Oct 1, 2024 Accepting new patients
Clark Dermatology, LLC Dermatology PastSince May 11, 2025 Accepting new patients
Jo-Ann Szylit, MD Dermatology PastSince Oct 1, 2024 Accepting new patients

Locations

1075 Central Ave
Clark, NJ 07066
Phone (732) 574-1399

469 Morris Ave
Ste 3
Elizabeth, NJ 07208
Phone (732) 574-1399

3202 John F Kennedy Blvd
Jersey City, NJ 07306
Phone (201) 332-4500

135 Kinnelon Rd
Rm 103
Kinnelon, NJ 07405
Phone (973) 838-1771

5809 Madison St
West New York, NJ 07093
Phone (201) 770-1370

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": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1033606249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5809 MADISON ST",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070931005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5809 MADISON ST",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070931005",
            "telephone_number": "201-861-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSALES SANTILLAN",
        "first_name": "MONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-13",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA12382700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West New York, NJ

Sources for this page

Verify at the official NPI Registry.