Gina Marie Miranda, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00399000 Issued in NJ

Practice address

100 Federal City Rd
Lawrenceville, NJ 08648-1664

Phone

(609) 620-1380

NPI assigned

Jul 8, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Gina Marie Mattiello Former name

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Doctors Office of Manalapan LLCGroup PAC ID 8022268069, 9 clinicians

Doctors Office of West Caldwell LLCGroup PAC ID 7416130448, 26 clinicians

Doctors Office of BrickGroup PAC ID 1254575061, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Doctor'S Office of West Caldwell LLC

  • Urgent Care Clinic/Center
  • West Caldwell, NJ
  • NPI 1144524786
  Medicare reassignment Care Compare group
• Doctors Office of Brick

  • Urgent Care Clinic/Center
  • Brick, NJ
  • NPI 1184067944
  Medicare reassignment Care Compare group
• The Doctors Office of Manalapan LLC

  • Emergency Medicine Physician
  • Manalapan, NJ
  • NPI 1356604409
  Medicare reassignment Care Compare group
• Excel Urgent Care of NJ LLC

  • Urgent Care Clinic/Center
  • Old Bridge, NJ
  • NPI 1255742243
  Medicare reassignment
• Excel Urgent Care of Paramus LLC

  • Internal Medicine Physician
  • Paramus, NJ
  • NPI 1063652220
  Medicare reassignment
• Jersey Irish Medical

  • Urgent Care Clinic/Center
  • Bound Brook, NJ
  • NPI 1144575739
  Medicare reassignment
• The Radiology Group of New Jersey, LLC

  • Multi-Specialty Clinic/Center
  • Hackettstown, NJ
  • NPI 1174010540
  NPD (past)

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1477905925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 GORHAM CT",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085276324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FEDERAL CITY RD",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086481664",
            "telephone_number": "609-620-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-08",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00399000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "MATTIELLO",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erica Mikula
• Miller Healthcare LLC
• Colleen Miller, NP
• Simon Milman, DMD
• Donna M Mininni, MS,CCC-SLP
• Doreen T Miri, MA,LPC,NCC
• Nidhi Singhal Modi, MD
• Joseph Durkheim Moise, MSN, APRN, FNP-BC
• Molly Weigel, LCSW, LLC
• Anne Monetti, DC

• Physician Assistant in Lawrenceville, NJ
• Providers in Lawrenceville, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; 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.

Verify at the official NPI Registry.