Individual provider Active NPI

Jennifer M Castellanos, PA-C

  • Physician Assistant
  • Franklin Lakes, NJ
National Provider Identifier
1386929263
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00260100
Practice address
784 Franklin Ave
Franklin Lakes, NJ 07417
Phone
(844) 281-1783
NPI assigned
Oct 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 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 25MP00260100 Primary

Addresses

Primary practice location

784 Franklin Ave
Franklin Lakes, NJ 07417

Mailing address

784 Franklin Ave Ste 250
Franklin Lakes, NJ 07417-1306
Phone (844) 777-0910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 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
I20181127002863 NJ Practitioner - Physician Assistant 4385988617 Reassigns benefits to 1 organization
I20201014001767 NY Practitioner - Physician Assistant 4385988617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kayal Medical Group, LLCGroup PAC ID 2961894019, 76 clinicians

Practice addresses (Care Compare)

260 Old Hook Rd
Suite 401
Westwood, NJ 07675-3123
Phone (844) 777-0910

266 Harristown Rd
Glen Rock, NJ 07452-3321
Phone (844) 777-0910

543 45TH St
Union City, NJ 07087-2615
Phone (844) 777-0910

784 Franklin Ave
Franklin Lakes, NJ 07417-1306
Phone (844) 777-0910

Hospital & facility affiliations

  • Hackensack Meridian Health Pascack Valley Medical Hospital, Westwood, NJ, CCN 310130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
014924NYMDMental Health Counselor

Interoperability endpoints

  • Direct secure messaging: jcastellanos198081@ahs.direct-ci.com

Organizations & group practices 2

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 1

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": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1386929263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 FRANKLIN AVE STE 250",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074171306",
            "telephone_number": "844-777-0910",
            "fax_number": "201-560-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 FRANKLIN AVE",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "07417",
            "telephone_number": "844-281-1783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTELLANOS",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "25MP00260100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin Lakes, NJ

Sources for this page

Verify at the official NPI Registry.