Individual provider Active NPI

Jaclyn Bonnafoux, DMSC PA-C

  • Physician Assistant
  • Paramus, NJ
National Provider Identifier
1154870202
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00410400 Issued in NJ
Practice address
230 E Ridgewood Ave
Paramus, NJ 07652-4142
Phone
(201) 398-8368
NPI assigned
Sep 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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 25MP00410400 NJ Primary

Addresses

Primary practice location

230 E Ridgewood Ave
Paramus, NJ 07652-4142

Mailing address

230 E Ridgewood Ave
Paramus, NJ 07652-4142

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
I20161221001494 NJ Practitioner - Physician Assistant 1850672395 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bergen County Improvement AuthorityGroup PAC ID 9032104047, 95 clinicians
Inhospital Physicians Corp of New Jersey, PCGroup PAC ID 2264781780, 20 clinicians

Practice addresses (Care Compare)

230 E Ridgewood Ave
Paramus, NJ 07652-4142
Phone (201) 967-4000

350 Boulevard
Passaic, NJ 07055-2840
Phone (973) 365-4300

Hospital & facility affiliations

  • Bergen New Bridge Medical Center Hospital, Paramus, NJ, CCN 310058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00410400NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc CurrentSince Mar 13, 2019 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Mar 13, 2019 Accepting new patients
Bergen County Improvement Authority CurrentSince Feb 1, 2021 Accepting new patients
Bergen County Improvement Authority CurrentSince Feb 1, 2021 Accepting new patients
Bergen County Improvement Authority Past Accepting new patients

Locations

30 Bergen St
Rm 1205
Newark, NJ 07107
Phone (973) 972-0037

140 Bergen St
#1680
Newark, NJ 07103
Phone (973) 972-4418

230 E Ridgewood Ave
Paramus, NJ 07652
Phone (201) 225-4700

230 E Ridgewood Ave
Bldg 10
Paramus, NJ 07652
Phone (201) 967-9020

350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300

680 Broadway
Ste 506
Paterson, NJ 07514
Phone (973) 500-2399

Organizations & group practices 9

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": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1154870202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E RIDGEWOOD AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076524142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E RIDGEWOOD AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076524142",
            "telephone_number": "201-398-8368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNAFOUX",
        "first_name": "JACLYN",
        "credential": "DMSC PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-30",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00410400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramus, NJ

Sources for this page

Verify at the official NPI Registry.