Organization Active NPI

Park Avenue Medical Associates, P.a.

  • Internal Medicine Physician
  • Lyndhurst, NJ
National Provider Identifier
1528261385
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA04207400 Issued in NJ
Legal business name
PARK AVENUE MEDICAL ASSOCIATES, P.A.
Practice address
30 Park Ave
Suite 202
Lyndhurst, NJ 07071-1000
Phone
(201) 438-5900
NPI assigned
Jun 8, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jane Hoskin, MDNPI 1194738195
Title
Vice-President
Phone
(201) 438-5900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA04207400 NJ Primary

Addresses

Primary practice location

30 Park Ave
Suite 202
Lyndhurst, NJ 07071-1000

Mailing address

30 Park Ave
Suite 202
Lyndhurst, NJ 07071-1000
Phone (201) 438-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050317000388 NJ Part B Supplier - Clinic/Group Practice 7618922196 Receives reassigned benefits from 3 practitioners
Practice locations: Lyndhurst, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0965454Park Avenue Medical Associates30 Park Avenue Suite 202, Lyndhurst, NJ 07071Certificate of waiverSep 20, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528261385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PARK AVE",
            "address_2": "SUITE 202",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070711000",
            "telephone_number": "201-438-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PARK AVE",
            "address_2": "SUITE 202",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070711000",
            "telephone_number": "201-438-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVENUE MEDICAL ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOSKIN",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "201-438-5900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04207400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyndhurst, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.