Individual provider Active NPI

Michelle Tuzzolino

  • Physician Assistant
  • Fair Lawn, NJ
National Provider Identifier
1366600140
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00199500 Issued in NJ
Practice address
17-17 Route 208
Fair Lawn, NJ 07410-2820
Phone
(201) 444-5200
Fax
(201) 796-3711
NPI assigned
May 28, 2008
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 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 25MP00199500 NJ Primary

Addresses

Primary practice location

17-17 Route 208
Fair Lawn, NJ 07410-2820

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104

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
I20110302000163 NJ Practitioner - Physician Assistant 6709951916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Nov 13, 2017 Accepting new patients
Summit Medical Group PA CurrentSince Nov 13, 2017 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

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

17-17 Route 208
Fair Lawn, NJ 07410
Phone (201) 345-7557

31-00 Broadway
Fair Lawn, NJ 07410
Phone (201) 791-7771

31-00 Broadway
Ste 2
Fair Lawn, NJ 07410
Phone (201) 796-2255

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

Interoperability endpoints

  • Direct secure messaging: michelle.tuzzolino.1@2983.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1366600140",
    "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",
            "fax_number": "201-796-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17-17 ROUTE 208",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102820",
            "telephone_number": "201-444-5200",
            "fax_number": "201-796-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUZZOLINO",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00199500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

Verify at the official NPI Registry.