Juan Camilo Victoria

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4675 Issued in NJ

Practice address

63 Grove St
Passaic, NJ 07055-5001

Phone

(908) 884-6740

NPI assigned

Jun 23, 2025

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

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Momentum Therapy ServicesGroup PAC ID 0840519278, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Momentum Therapy Services

  • Speech-Language Pathologist
  • Lakewood, NJ
  • NPI 1811302870
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1265329916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "374 BOULEVARD",
            "city": "KENILWORTH",
            "state": "NJ",
            "postal_code": "070331530",
            "telephone_number": "908-884-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 GROVE ST",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070555001",
            "telephone_number": "908-884-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORIA",
        "first_name": "JUAN",
        "middle_name": "CAMILO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "4675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Velazquez, O.D.
• Irving Velez, M.ED., NCC,
• Ravi Kumar Venkataraman, MD
• Gopikrishna Venkatesvaran, MBBS
• Evelyn Ventura, MD
• Amarilis Villanueva, APN
• Cassandra Vincent, PA
• Olga Vinnik, RN, BSN, IBCLC
• Luz Stella Viola, LSW
• Tarika-Deep Virdi, RPA-C

• Speech-Language Pathologist in Passaic, NJ
• Providers in Passaic, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.