Individual provider Active NPI

Michelle Susan Vitale, A.P.N.

  • Family Nurse Practitioner
  • Paterson, NJ
National Provider Identifier
1114299914
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00365700 Issued in NJ
Practice address
154 Union Ave
Paterson, NJ 07502-1849
Phone
(973) 942-3618
Fax
(973) 942-7224
NPI assigned
Feb 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00365700 NJ Primary

Addresses

Primary practice location

154 Union Ave
Paterson, NJ 07502-1849

Mailing address

154 Union Ave
Paterson, NJ 07502-1849
Phone (973) 942-3618

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
I20120418000169 NJ Practitioner - Nurse Practitioner 5395906317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Paterson Family Medical Center, PAGroup PAC ID 4880766922, 4 clinicians

Practice addresses (Care Compare)

1031 McBride Ave
D109
West Paterson, NJ 07424-2568

154 Union Ave
Paterson, NJ 07502-1849
Phone (973) 942-3618

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Paterson Family Medical Center,PA CurrentSince Mar 31, 2017 Accepting new patients
St Josephs University Medical Center Inc. Past Accepting new patients

Locations

154 Union Ave
Paterson, NJ 07502
Phone (973) 942-3618

1031 McBride Ave
Ste D109
Woodland Park, NJ 07424
Phone (973) 785-4020

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AEDADD/Endpoint/AEDADD

Organizations & group practices 2

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 2

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": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1114299914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 UNION AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075021849",
            "telephone_number": "973-942-3618",
            "fax_number": "973-942-7224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 UNION AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075021849",
            "telephone_number": "973-942-3618",
            "fax_number": "973-942-7224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALE",
        "first_name": "MICHELLE",
        "middle_name": "SUSAN",
        "name_prefix": "Miss",
        "credential": "A.P.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00365700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.