Individual provider Active NPI

Anastasiya Mulyar, PA-C

  • Physician Assistant
  • Vineland, NJ
National Provider Identifier
1104532803
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00758100 Issued in NJ
Practice address
1206 W Sherman Ave BLDG 2a
Vineland, NJ 08360-6911
Phone
(856) 696-9933
NPI assigned
Jan 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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 25MP00758100 NJ Primary

Addresses

Primary practice location

1206 W Sherman Ave BLDG 2a
Vineland, NJ 08360-6911

Mailing address

137 Alpine Way
Vineland, NJ 08360-9352
Phone (609) 579-3845

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
I20230322000043 NJ Practitioner - Physician Assistant 4981078540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inspira Health Network Medical Group PCGroup PAC ID 4880797570, 238 clinicians

Practice addresses (Care Compare)

798 Centerton Rd
Pittsgrove, NJ 08318-3945
Phone (856) 358-6161

Hospital & facility affiliations

  • Inspira Medical Center Vineland Hospital, Vineland, NJ, CCN 310032

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00758100NJMDPhysician Assistant

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1104532803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 ALPINE WAY",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083609352",
            "telephone_number": "609-579-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 W SHERMAN AVE BLDG 2A",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606911",
            "telephone_number": "856-696-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULYAR",
        "first_name": "ANASTASIYA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-25",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00758100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

Verify at the official NPI Registry.