Jason R Jannicelli, MS PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00151700 Issued in NJ

Practice address

110 Rehill Ave # 08876
Somerville, NJ 08876-2519

Phone

(908) 685-2200

NPI assigned

Apr 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jjannicelli42206@epicdirect.rwjbh.org

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.

• Robert Wood Johnson Medical Associates

  • Hospitalist Physician
  • New Brunswick, NJ
  • NPI 1902848625
  Medicare reassignment
• Rutgers Health-RWJ Neurosurgery Faculty

  • Urology Physician
  • New Brunswick, NJ
  • NPI 1710012604
  Medicare reassignment
• Rutgers Health-RWJ Neurosurgery Faculty

  • Pediatric Surgery Physician
  • New Brunswick, NJ
  • NPI 1487736146
  NPD
• Rutgers Health-RWJ Neurosurgery Faculty

  • Durable Medical Equipment & Medical Supplies
  • Neptune, NJ
  • NPI 1861290744
  NPD

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1225095607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 ARDEN RD",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571888",
            "telephone_number": "908-377-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 REHILL AVE # 08876",
            "city": "SOMERVILLE",
            "state": "NJ",
            "postal_code": "088762519",
            "telephone_number": "908-685-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANNICELLI",
        "first_name": "JASON",
        "middle_name": "R",
        "credential": "MS PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00151700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J. Rowden Opticians Incorportated
• Kara M Jacobs, MD
• Douglas Jacobus, DDS, MD
• Jacqueline Stadler, LCSW, LLC
• Rubama Jahangir, APN
• Seher Javaid, MD
• Jay Ann Shop, Inc.
• Jose S Jean Philippe
• Debra J Jelinek, RPH
• Jersey Central Chiropractic Health and Wellness, LLC

• Physician Assistant in Somerville, NJ
• Providers in Somerville, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.