Individual provider Active NPI

Reema Mistry, PA-C

  • Physician Assistant
  • Glen Ridge, NJ
National Provider Identifier
1295622447
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00950200 Issued in NJ
Practice address
200 Highland Ave Ste 100B
Glen Ridge, NJ 07028-1521
Phone
(973) 969-3800
NPI assigned
Jun 20, 2025
Last updated
Jun 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00950200 NJ Primary

Addresses

Primary practice location

200 Highland Ave Ste 100B
Glen Ridge, NJ 07028-1521

Mailing address

200 Highland Ave Ste 100B
Glen Ridge, NJ 07028-1521
Phone (973) 969-3800

Other practice location 1

1114 Goffle Rd Ste 104
Hawthorne, NJ 07506-2014
Phone (973) 636-9000

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250829004873 NJ Practitioner - Physician Assistant 2365943347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vanguard Medical Group PAGroup PAC ID 5092751842, 59 clinicians

Practice addresses (Care Compare)

200 Highland Ave
Suite 100B
Glen Ridge, NJ 07028-1521
Phone (973) 969-3800

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care for the Homebound PA CurrentSince Aug 25, 2025 Accepting new patients

Locations

1114 Goffle Rd
Ste 104
Hawthorne, NJ 07506
Phone (973) 636-9000

271 Grove Ave
Ste A
Verona, NJ 07044
Phone (973) 239-2600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25493/brand/1/csg/1/fhir/r4
  • Direct secure messaging: reema.mistry.1@25493.direct.athenahealth.com

Organizations & group practices 2

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": "1750377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1295622447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HIGHLAND AVE STE 100B",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281521",
            "telephone_number": "973-969-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HIGHLAND AVE STE 100B",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281521",
            "telephone_number": "973-969-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1114 Goffle Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Hawthorne",
            "state": "NJ",
            "postal_code": "075062014",
            "country_code": "US",
            "telephone_number": "973-636-9000",
            "fax_number": "833-493-1245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MISTRY",
        "first_name": "REEMA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-20",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00950200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ridge, NJ

Sources for this page

Verify at the official NPI Registry.