Iwona Pedatella, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00290300 Issued in NJ

Practice address

221 W Grand Ave
Montvale, NJ 07645-1729

Phone

(201) 307-0075

NPI assigned

Nov 21, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: iwonapedatella@abelesdermatology.medentdirect.com

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.

• Enhance Dermatology, PC

  • Procedural Dermatology Physician
  • Montvale, NJ
  • NPI 1720236110
  Medicare reassignment

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

{
    "created_epoch": "1353456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353456000000",
    "number": "1043554512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 RIVERDALE RD",
            "address_2": "402",
            "city": "RIVERDALE",
            "state": "NJ",
            "postal_code": "074571729",
            "telephone_number": "973-896-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W GRAND AVE",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451729",
            "telephone_number": "201-307-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDATELLA",
        "first_name": "IWONA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-21",
        "last_updated": "2012-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00290300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pascack Valley Speech and Language Services
• Dipal Patel, P.T.
• Shivani Bharat Patel, D.O.
• Pathmark Stores Inc
• PCN Medical Group, LLC
• Janet Borrello Peppard, APN, RN
• Zachary Pereira, LSW
• Julia Lynn Perez, PT, DPT
• Perio Implant Moon LLC
• Lori Marie Pernal, OTR/L

• Medical Physician Assistant in Montvale, NJ
• Providers in Montvale, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.