Individual provider Active NPI

Addi Michelle Georgantzis

  • Adult Health Nurse Practitioner
  • Englewood, NJ
National Provider Identifier
1083280317
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ01110300 Issued in NJ
Practice address
350 Engle St
Englewood, NJ 07631-1808
Phone
(201) 894-3000
NPI assigned
May 27, 2021
Last updated
May 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F309828 NY
Adult Health Nurse Practitioner 363LA2200X 26NJ01110300 NJ Primary

Addresses

Primary practice location

350 Engle St
Englewood, NJ 07631-1808

Mailing address

550 1St Ave
New York, NY 10016-6402
Phone (212) 263-8134

Other practice location 1

92 2nd St
Hackensack, NJ 07601-2191
Phone (551) 996-8297

Other identifiers 1

IdentifierTypeStateIssuer
1083280317MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210727001780 NY Practitioner - Nurse Practitioner 6800299967 Reassigns benefits to 1 organization
I20250804003779 NJ Practitioner - Nurse Practitioner 6800299967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01110300NJMDAdult Health Nurse Practitioner
F309828NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Multi-Specialty CurrentSince Jul 1, 2021 Accepting new patients
New York University Multi-Specialty CurrentSince Jul 1, 2021 Accepting new patients
Medical Associates of Englewood, PC Multi-Specialty CurrentSince Sep 15, 2025 Accepting new patients

Locations

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

550 1st Ave
New York, NY 10016
Phone (212) 263-3293

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1083280317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-8134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311808",
            "telephone_number": "201-894-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "92 2nd St",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076012191",
            "country_code": "US",
            "telephone_number": "551-996-8297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGANTZIS",
        "first_name": "ADDI",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F309828",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ01110300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083280317",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.