Vashti Etwaru

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

013232 Issued in NY

Practice address

649 Morris Ave
Springfield, NJ 07081-1526

Phone

(973) 795-7955

NPI assigned

Aug 18, 2009

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1114159506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CROWN VIEW CT",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078713569",
            "telephone_number": "516-343-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 MORRIS AVE",
            "city": "SPRINGFIELD",
            "state": "NJ",
            "postal_code": "070811526",
            "telephone_number": "973-795-7955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETWARU",
        "first_name": "VASHTI",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-18",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "013232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Kathryn Emery, MS
• Kathleen K Escobia, NP
• Junior Espinal
• Essex Union Podiatry LLP
• Rafael Estrella, DDS
• Exceptional Eye Care Group of Springfield L.L.C.
• Eye Health Group of Springfield, LLC
• Eye Health Group of TR LLC
• Ana Noemi Falcon, MA
• Jody Fenelon, RPH

• Medical Physician Assistant in Springfield, NJ
• Providers in Springfield, 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 Jul 10, 2023; 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.