Individual provider Active NPI

Sondra J Patella, MSN;RN;ANP,C

  • Nurse Practitioner
  • New Brunswick, NJ
National Provider Identifier
1417031113
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NN 073508 Issued in NJ
Practice address
125 Paterson St
5TH Floor Suite 5200
New Brunswick, NJ 08901-1962
Phone
(732) 235-6561
Fax
(732) 235-6530
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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 26NN07350800 NJ
Nurse Practitioner 363L00000X NN 073508 NJ Primary

Addresses

Primary practice location

125 Paterson St
5TH Floor Suite 5200
New Brunswick, NJ 08901-1962

Mailing address

125 Paterson St
5TH Floor Suite 5200
New Brunswick, NJ 08901-1962
Phone (732) 235-6561

Other identifiers 4

IdentifierTypeStateIssuer
1094178OtherNJHORIZON NJ HEALTH
7549105MedicaidNJ
890000846OtherNJRAILROAD MEDICARE
P1251016OtherNJOXFORD

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
I20101209000574 NJ Practitioner - Nurse Practitioner 6305033879 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NN 073508NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Scleroderma Program CurrentSince Feb 1, 2021 Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program Current Accepting new patients
Rutgers Health-RWJ Scleroderma Program Past Accepting new patients
University Hospital Past Accepting new patients
University Hospital PastSince May 1, 2008 Accepting new patients

Locations

125 Paterson St
Ste 5100A
New Brunswick, NJ 08901
Phone (609) 655-5175

125 Paterson St
New Brunswick, NJ 08901
Phone (732) 235-6511

195 Little Albany St
Ste 1134
New Brunswick, NJ 08901
Phone (732) 235-2465

125 Paterson St
Ste 6100
New Brunswick, NJ 08901
Phone (732) 235-6561

125 Paterson St
Ste 5100
New Brunswick, NJ 08901
Phone (732) 235-7060

125 Paterson St
#5200A
New Brunswick, NJ 08901
Phone (732) 235-7217

195 Little Albany St
New Brunswick, NJ 08901
Phone (732) 235-2465

125 Paterson St
Fl 5
New Brunswick, NJ 08901
Phone (732) 235-6561

1 Robert Wood Johnson Pl
Ste 4
New Brunswick, NJ 08901

Organizations & group practices 7

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1417031113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST",
            "address_2": "5TH FLOOR SUITE 5200",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962",
            "telephone_number": "732-235-6561",
            "fax_number": "732-235-6530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST",
            "address_2": "5TH FLOOR SUITE 5200",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962",
            "telephone_number": "732-235-6561",
            "fax_number": "732-235-6530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATELLA",
        "first_name": "SONDRA",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "MSN;RN;ANP,C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NN07350800",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "NN 073508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1094178",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7549105",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "890000846",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1251016",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.