Individual provider Active NPI

Pamela A Deandrea, APN

  • Acute Care Nurse Practitioner
  • Matawan, NJ
National Provider Identifier
1114177045
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NJ00168700 Issued in NJ
Practice address
177 Main St
Matawan, NJ 07747-4107
Phone
(609) 890-1050
Fax
(609) 890-0950
NPI assigned
Sep 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 26NJ00168700 NJ Primary

Addresses

Primary practice location

177 Main St
Matawan, NJ 07747-4107

Mailing address

PO Box 830826
Philadelphia, PA 19182-0826
Phone (609) 890-1050

Other names 1

  • Pamela Anne Rose Former name

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
I20090105000435 NJ Practitioner - Nurse Practitioner 7113080904 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Azz Medical Associates PCGroup PAC ID 6002132685, 63 clinicians

Practice addresses (Care Compare)

631 Broadway
Suite B 2
Bayonne, NJ 07002-3846
Phone (609) 890-1050

Hospital & facility affiliations

  • Patient Care Home health agency, West Orange, NJ, CCN 317060

Merit-based Incentive Payment System (MIPS)

Final score
82.88 of 100Reported as group
Quality
81.99
Promoting interoperability
95
Improvement activities
20
Cost
69.63

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Freeway Psychiatry PC CurrentSince Feb 1, 2023 Accepting new patients
Azz Medical Associates PC CurrentSince Dec 1, 2025 Accepting new patients
Matawan Aberdeen Heart & Medical Center PastSince Oct 11, 2009 Accepting new patients

Locations

631 Broadway
Ste 2
Bayonne, NJ 07002

631 Broadway
Ste B2
Bayonne, NJ 07002
Phone (201) 823-4400

1440 Pennington Rd
Ste 1
Ewing, NJ 08618
Phone (609) 422-7928

177 Main St
Matawan, NJ 07747
Phone (732) 566-6614

9225 Kennedy Blvd
#F
North Bergen, NJ 07047
Phone (201) 500-9755

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.

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": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1114177045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 830826",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191820826",
            "telephone_number": "609-890-1050",
            "fax_number": "609-890-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 MAIN ST",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077474107",
            "telephone_number": "609-890-1050",
            "fax_number": "609-890-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANDREA",
        "first_name": "PAMELA",
        "middle_name": "A",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ00168700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "ROSE",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Matawan, NJ

Sources for this page

Verify at the official NPI Registry.