NPIMap

Individual provider Active NPI

Andria Jynelle Williams, PA-C

  • Physician Assistant
  • Bryn Mawr, PA
National Provider Identifier
1265681316
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00217100 Issued in NJ
Practice address
130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121
Phone
(484) 337-3770
NPI assigned
Sep 13, 2008
Last updated
Oct 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

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 25MP00217100 NJ Primary
Medical Physician Assistant 363AM0700X MA053594 PA

Addresses

Primary practice location

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121

Mailing address

70 Lindsey Ave
Runnemede, NJ 08078-1731
Phone (856) 371-8093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111202000072 NJ Practitioner - Physician Assistant 7517095409 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Office of West Caldwell LLCGroup PAC ID 7416130448, 26 clinicians
Doctors Office of BrickGroup PAC ID 1254575061, 13 clinicians

Practice addresses (Care Compare)

556 Passaic Ave
West Caldwell, NJ 07006-7449
Phone (973) 808-2273

686 Route 70
Brick, NJ 08723-4026
Phone (732) 262-8200

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00217100NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2023 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jan 1, 2023 Accepting new patients
Meridian Trauma Associates, P.C. Past Accepting new patients
The Radiology Group of New Jersey, LLC Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

1140 Route 72 W
Stafford Township, NJ 08050
Phone (609) 978-2194

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

425 Jack Martin Blvd
Wall Township, NJ 08724
Phone (732) 840-2200

Interoperability endpoints

  • Direct secure messaging: andria.williams@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1221264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1265681316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 LINDSEY AVE",
            "city": "RUNNEMEDE",
            "state": "NJ",
            "postal_code": "080781731",
            "telephone_number": "856-371-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S BRYN MAWR AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103121",
            "telephone_number": "484-337-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ANDRIA",
        "middle_name": "JYNELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-13",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00217100",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA053594",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryn Mawr, PA

Sources for this page

Verify at the official NPI Registry.