Individual provider Active NPI

Rose Michelle Mojares, PA-C

  • Physician Assistant
  • Summit, NJ
National Provider Identifier
1386817518
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00143200 Issued in NJ
Practice address
47 Maple St
Suite 406
Summit, NJ 07901-2571
Phone
(908) 918-0001
NPI assigned
Apr 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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 25MP00143200 NJ Primary

Addresses

Primary practice location

47 Maple St
Suite 406
Summit, NJ 07901-2571

Mailing address

11 Sire Stakes Dr
Tinton Falls, NJ 07724-2879
Phone (732) 544-1533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25MP00143200NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Plastic Surgery, PC 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": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1386817518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 SIRE STAKES DR",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077242879",
            "telephone_number": "732-544-1533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 MAPLE ST",
            "address_2": "SUITE 406",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079012571",
            "telephone_number": "908-918-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOJARES",
        "first_name": "ROSE MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-09",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00143200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.