Individual provider Active NPI

Coralie Guerdat

  • Physician Assistant
  • Union, NJ
National Provider Identifier
1205565462
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1057 Commerce Ave
Union, NJ 07083-5025
Phone
(908) 688-8800
Fax
(908) 688-2377
NPI assigned
Jun 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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 Primary

Addresses

Primary practice location

1057 Commerce Ave
Union, NJ 07083-5025

Mailing address

1057 Commerce Ave
Union, NJ 07083-5025
Phone (908) 688-8800

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
I20240918002811 NJ Practitioner - Physician Assistant 4385185347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Northwestern University Feinberg Medical School, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Igea Brain and Spine,PAGroup PAC ID 2769418037, 18 clinicians

Practice addresses (Care Compare)

1057 Commerce Ave
Union, NJ 07083-5025
Phone (908) 688-8800

Hospital & facility affiliations

  • Robert Wood Johnson University Hospital - Somerset Hospital, Somerville, NJ, CCN 310048
  • Trinitas Regional Medical Center Hospital, Elizabeth, NJ, CCN 310027
  • Morristown Medical Center Hospital, Morristown, NJ, CCN 310015
  • Overlook Medical Center Hospital, Summit, NJ, CCN 310051

National Provider Directory

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

Organizations & group practices 1

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 7

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": "1654387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1205565462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 COMMERCE AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835025",
            "telephone_number": "908-688-8800",
            "fax_number": "908-688-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 COMMERCE AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835025",
            "telephone_number": "908-688-8800",
            "fax_number": "908-688-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERDAT",
        "first_name": "CORALIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-05",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.