Nilla Defazio, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00034900 Issued in NJ

Practice address

1 Bay Ave
Montclair, NJ 07042-4837

Phone

(973) 429-6695

NPI assigned

Mar 29, 2006

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Emergency Physician Associates of North Jersey P C

  • Emergency Medicine Physician
  • Summit, NJ
  • NPI 1497783419

  NJ

  Medicare reassignment
• Emergency Physician Associates of South Jersey P C

  • Emergency Medicine Physician
  • Voorhees, NJ
  • NPI 1215965231

  NJ

  Medicare reassignment
• Hospitalist Physicians of New Jersey PA

  • Hospitalist Physician
  • Edison, NJ
  • NPI 1588021851

  NJ

  Medicare reassignment
• Middlesex Emergency Physicians, P.a.

  • Emergency Medicine Physician
  • Edison, NJ
  • NPI 1811921760

  NJ

  Medicare reassignment
• Anthony S Lombardi MD PC

  • Plastic Surgery Physician
  • Eatontown, NJ
  • NPI 1679548119
  NPD (past)
• Atlantic Professional Services of New Jersey, P.a.

  • Physician Assistant
  • Stratford, NJ
  • NPI 1932145182
  NPD (past)
• Emergency Medical Associates of New Jersey PA

  • Emergency Medicine Physician
  • Long Branch, NJ
  • NPI 1841456068
  NPD (past)
• Evergreen Emergency Solutions, PC

  • Emergency Medicine Physician
  • Montclair, NJ
  • NPI 1558349274
  NPD (past)
• Plainfield Emergency Physicians, PA

  • Emergency Medicine Physician
  • Plainfield, NJ
  • NPI 1659309680

  Physician Assistant

  NPD (past)
• Tidal Emergency Physicians LLC

  • Emergency Medicine Physician
  • Neptune, NJ
  • NPI 1649222407
  NPD (past)

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1336100486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 CROASDAILE DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277052505",
            "telephone_number": "919-425-1564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAY AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424837",
            "telephone_number": "973-429-6695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFAZIO",
        "first_name": "NILLA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00034900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alina De Almeida, RD
• Constance De Martino
• Bonu Decaires, CD(DONA), CCE
• Dedicated Primary Care LLC
• Michael Kevin Deenihan, D.D.S.
• Kelli Deflora, CD(DONA)
• Mathilde Battsek Degraff, PT, DPT,
• Gary Chris Degrande, M.D.
• Jillian Degroot
• Jo-Ann S Dejean, DNP, APN,AGNP-C

• All providers in Montclair, NJ
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.