Individual provider Active NPI

Risa Ann Cohen-Vergara, RPAC

  • Medical Physician Assistant
  • Edison, NJ
National Provider Identifier
1184913683
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00117400 Issued in NJ
Practice address
65 James St
Edison, NJ 08820-3947
Phone
(732) 321-7000
NPI assigned
Apr 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 002720 NY
Medical Physician Assistant 363AM0700X 25MP00117400 NJ Primary

Addresses

Primary practice location

65 James St
Edison, NJ 08820-3947

Mailing address

3600 Route 66 FL 3
Neptune, NJ 07753-2645

Other practice location 1

1st ave at 16th street
Department of neonatology 6 Baird
New York, NY 10003
Phone (908) 420-4170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002720NYMDPhysician Assistant
25MP00117400NJMDMedical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1184913683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 66 FL 3",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077532645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 JAMES ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203947",
            "telephone_number": "732-321-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1st ave at 16th street",
            "address_2": "Department of neonatology 6 Baird",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10003",
            "country_code": "US",
            "telephone_number": "908-420-4170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COHEN-VERGARA",
        "first_name": "RISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RPAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "002720",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00117400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.