Jill Kathleen McGovern, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00562300 Issued in NJ

Practice address

106 Prospect Street
3Rd Floor
Ridgewood, NJ 07450-4433

Phone

(201) 639-2656

NPI assigned

Mar 7, 2020

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Preferred Pediatric Orthopedic Surgery LLC

  • Pediatric Orthopaedic Surgery Physician
  • Ridgewood, NJ
  • NPI 1003384918
  NPD (past)

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

{
    "created_epoch": "1583539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583539200000",
    "number": "1295360576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 DEMAREST AVENUE",
            "city": "ORADELL",
            "state": "NJ",
            "postal_code": "076491703",
            "telephone_number": "201-527-7922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 PROSPECT STREET",
            "address_2": "3RD FLOOR",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504433",
            "telephone_number": "201-639-2656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOVERN",
        "first_name": "JILL",
        "middle_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-07",
        "last_updated": "2020-03-07",
        "certification_date": "2020-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00562300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace McAlindin, LCSW
• Lauren T McCarthy Debiak, LCSW
• Marianne McCormack, L.C.S.W.
• Rachel McDonough
• Francis Eugene McGorty, MD
• Kayla Michelle McGovern, PA-C
• John Joseph McGreal, MD
• Mary C McGuinness, APN
• Patricia Lee McGuire, MD
• William P McGuire, DDS

• Physician Assistant in Ridgewood, NJ
• Providers in Ridgewood, 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 Mar 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.