Active NPI
Juan Fernando Osorio
- Physician Assistant
- Newark, NJ
National Provider Identifier
1457039505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1731
- Practice address
- 393 Central Ave
Newark, NJ 07103-2842 - Phone
- (973) 483-3444
- Fax
- (973) 849-0117
- NPI assigned
- Jul 10, 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 | 1731 | PR | Primary |
Addresses
Primary practice location
393 Central Ave
Newark, NJ 07103-2842
Mailing address
393 Central Ave
Newark, NJ 07103-2842
Phone (973) 483-3444
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1731 | PR | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688947200000",
"number": "1457039505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "393 CENTRAL AVE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071032842",
"telephone_number": "973-483-3444",
"fax_number": "973-849-0117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "393 CENTRAL AVE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071032842",
"telephone_number": "973-483-3444",
"fax_number": "973-849-0117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSORIO",
"first_name": "JUAN",
"middle_name": "FERNANDO",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-10",
"last_updated": "2023-07-10",
"certification_date": "2023-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PR",
"license": "1731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.