Individual provider Active NPI

Joel Cordero Garcesa, APN-C

  • Adult Health Nurse Practitioner
  • Perth Amboy, NJ
National Provider Identifier
1407235427
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00555700 Issued in NJ
Practice address
530 New Brunswick Ave
Perth Amboy, NJ 08861-3654
Phone
(732) 324-5042
NPI assigned
May 22, 2015
Last updated
May 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00555700 NJ Primary
Registered Nurse 163W00000X 26NR08871000 NJ

Addresses

Primary practice location

530 New Brunswick Ave
Perth Amboy, NJ 08861-3654

Mailing address

530 New Brunswick Ave
Perth Amboy, NJ 08861-3654
Phone (732) 324-5042

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
I20150716000518 NJ Practitioner - Nurse Practitioner 3274846514 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NR08871000NJMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Associates of Montclair LLC CurrentSince Aug 9, 2017 Accepting new patients
Robert Wood Johnson Medical Associates CurrentSince Jun 2, 2015 Accepting new patients

Locations

1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

66 W Gilbert St
Tinton Falls, NJ 07701
Phone (732) 212-0051

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432252800000",
    "number": "1407235427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 NEW BRUNSWICK AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613654",
            "telephone_number": "732-324-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NEW BRUNSWICK AVE",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613654",
            "telephone_number": "732-324-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCESA",
        "first_name": "JOEL",
        "middle_name": "CORDERO",
        "credential": "APN-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-22",
        "last_updated": "2015-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00555700",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR08871000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

Verify at the official NPI Registry.