Individual provider Active NPI

Jessica Anna Lidwin, PA-C

  • Physician Assistant
  • Summit, NJ
National Provider Identifier
1386596799
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00998600 Issued in NJ
Practice address
33 Overlook Rd Ste 301
Summit, NJ 07901-3563
Phone
(908) 522-5045
Fax
(908) 522-5353
NPI assigned
Feb 10, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 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 25MP00998600 NJ Primary

Addresses

Primary practice location

33 Overlook Rd Ste 301
Summit, NJ 07901-3563

Mailing address

PO Box 416457
Boston, MA 02241-6457
Phone (844) 362-1735

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
I20260602002743 NJ Practitioner - Physician Assistant 9830660703 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

465 S St
Suite 103
Morristown, NJ 07960

465 S St
Suite 103
Morristown, NJ 07960-6442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MP00998600NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1770681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1386596799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "844-362-1735",
            "fax_number": "973-290-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 OVERLOOK RD STE 301",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013563",
            "telephone_number": "908-522-5045",
            "fax_number": "908-522-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIDWIN",
        "first_name": "JESSICA",
        "middle_name": "ANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-10",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00998600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.