Individual provider Active NPI

Anzule Navarrete

  • Medical Physician Assistant
  • Belleville, NJ
National Provider Identifier
1619580107
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00567800 Issued in NJ
Practice address
163 Belleville Ave
Belleville, NJ 07109-2437
Phone
(973) 302-4644
NPI assigned
Aug 25, 2020
Last updated
May 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MP00567800 NJ
Medical Physician Assistant 363AM0700X 25MP00567800 NJ Primary

Addresses

Primary practice location

163 Belleville Ave
Belleville, NJ 07109-2437

Mailing address

10 Southboro LN
Glen Rock, NJ 07452-2721
Phone (201) 686-0725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220525002834 NJ Practitioner - Physician Assistant 6901284330 Reassigns benefits to 1 organization
I20230206002573 NY Practitioner - Physician Assistant 6901284330 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00567800NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Feb 1, 2022 Accepting new patients
Montefiore Medical Center Pediatrics CurrentSince Feb 1, 2022 Accepting new patients
Prospect Pediatrics PA Pediatrics PastSince May 22, 2022 Accepting new patients
Montefiore Medical Center Pediatrics Past Accepting new patients
New Jersey Medical and Health Associates,LLC PastSince Aug 1, 2020 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

785 State Route 17M
Monroe, NY 10950
Phone (845) 356-2900

100 Corporate Dr
Ste 100
Yonkers, NY 10701
Phone (914) 378-6148

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: anavarrete1779715@nychhc.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1619580107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SOUTHBORO LN",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074522721",
            "telephone_number": "201-686-0725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 BELLEVILLE AVE",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071092437",
            "telephone_number": "973-302-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAVARRETE",
        "first_name": "ANZULE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-25",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MP00567800",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00567800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, NJ

Sources for this page

Verify at the official NPI Registry.