Active NPI
Giancarlo David Cortez, PA
- Physician Assistant
- Jersey City, NJ
National Provider Identifier
1457035362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 25MP00774900
- Practice address
- 550 Newark Ave Ste 307
Jersey City, NJ 07306-1353 - Phone
- (201) 418-9111
- NPI assigned
- Jun 12, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00774900 | NJ | Primary |
Addresses
Primary practice location
550 Newark Ave Ste 307
Jersey City, NJ 07306-1353
Mailing address
247 Elm St
Elmwood Park, NJ 07407-1544
Phone (201) 824-3310
Other practice location 1
3916 Kennedy Blvd
Union City, NJ 07087-7887
Phone (201) 624-1877
Other practice location 2
433 60th St Fl 1
West New York, NJ 07093-2211
Phone (201) 770-9995
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
550 Newark Ave
Suite 307
Jersey City, NJ 07306-1353
Phone (201) 418-9111
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00774900 | NJ | MD | Physician Assistant |
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.
-
- Cardiovascular Disease Physician
- Jersey City, NJ
- NPI 1639481583
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1457035362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "247 ELM ST",
"city": "ELMWOOD PARK",
"state": "NJ",
"postal_code": "074071544",
"telephone_number": "201-824-3310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 NEWARK AVE STE 307",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073061353",
"telephone_number": "201-418-9111"
}
],
"practiceLocations": [
{
"address_1": "3916 Kennedy Blvd",
"address_purpose": "LOCATION",
"city": "Union City",
"state": "NJ",
"postal_code": "070877887",
"country_code": "US",
"telephone_number": "201-624-1877",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "433 60th St Fl 1",
"address_purpose": "LOCATION",
"city": "West New York",
"state": "NJ",
"postal_code": "070932211",
"country_code": "US",
"telephone_number": "201-770-9995",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CORTEZ",
"first_name": "GIANCARLO",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-12",
"last_updated": "2023-06-15",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00774900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.