NPIMap

Individual provider Active NPI

Christina Vassallo, APN

  • Nurse Practitioner
  • Montclair, NJ
National Provider Identifier
1265795181
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00382400 Issued in NJ
Practice address
62 S Fullerton Ave
Montclair, NJ 07042-2676
Phone
(973) 706-2171
Fax
(973) 780-9688
NPI assigned
Jun 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00382400 NJ
Nurse Practitioner 363L00000X 26NJ00382400 NJ Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 26NJ00382400 NJ

Addresses

Primary practice location

62 S Fullerton Ave
Montclair, NJ 07042-2676

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Other practice location 1

311 Bay Ave
Glen Ridge, NJ 07028-1607
Phone (973) 744-3733

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
I20121231000152 NJ Practitioner - Nurse Practitioner 6608029533 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MPV New Jersey MD Services PC CurrentSince Jul 16, 2017 Accepting new patients
MPV New Jersey MD Services PC CurrentSince Jul 16, 2017 Accepting new patients
Summit Medical Group PA CurrentSince Sep 11, 2023 Accepting new patients
Summit Medical Group PA CurrentSince Sep 11, 2023 Accepting new patients
Summit Medical Group, Inc Nurse Practitioner Past Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

311 Bay Ave
Glen Ridge, NJ 07028
Phone (973) 748-9166

123 Highland Ave
Ste 301
Glen Ridge, NJ 07028
Phone (973) 744-3733

1 Seymour St
Montclair, NJ 07042
Phone (973) 302-6025

150 Floral Ave
New Providence, NJ 07974
Phone (908) 588-3890

Interoperability endpoints

  • Direct secure messaging: christina.vassallo@direct.carepointhealth.org
  • Direct secure messaging: christina.vassallo.1@2983.direct.athenahealth.com

Organizations & group practices 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1265795181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 S FULLERTON AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422676",
            "telephone_number": "973-706-2171",
            "fax_number": "973-780-9688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 Bay Ave",
            "address_purpose": "LOCATION",
            "city": "Glen Ridge",
            "state": "NJ",
            "postal_code": "070281607",
            "country_code": "US",
            "telephone_number": "973-744-3733",
            "fax_number": "973-707-5821",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VASSALLO",
        "first_name": "CHRISTINA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2023-10-13",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00382400",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00382400",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "26NJ00382400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

Verify at the official NPI Registry.