Individual provider Active NPI

Jackie Garcia-Du, PA-C

  • Physician Assistant
  • Paterson, NJ
National Provider Identifier
1386050649
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00387300 Issued in NJ
Practice address
703 Main St
Paterson, NJ 07503-2621
Phone
(973) 754-2000
NPI assigned
Jul 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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 25MP00387300 NJ Primary

Addresses

Primary practice location

703 Main St
Paterson, NJ 07503-2621

Mailing address

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200604001651 NY Practitioner - Physician Assistant 2365863032 Reassigns benefits to 2 organizations
I20221102002387 NJ Practitioner - Physician Assistant 2365863032 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical Group PCGroup PAC ID 8628470325, 217 clinicians

Practice addresses (Care Compare)

703 Main St
Paterson, NJ 07503-2621

Hospital & facility affiliations

  • St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019
  • Chilton Medical Center Hospital, Pompton Plains, NJ, CCN 310017

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wyckoff Professional Medical Services, PC CurrentSince Apr 1, 2021 Accepting new patients
Trustees of Columbia University in the City of New York Physician Assistant CurrentSince Apr 11, 2020 Accepting new patients
Passaic River Physicians, LLC CurrentSince Sep 25, 2022 Accepting new patients

Locations

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1386050649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA-DU",
        "first_name": "JACKIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00387300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.