Individual provider Active NPI

Juan P Acosta, MD

  • Dermatology Physician
  • Montclair, NJ
National Provider Identifier
1629713094
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
25MA13144600 Issued in NJ
Practice address
1 Seymour St FL 6
Montclair, NJ 07042-3771
Phone
(973) 302-9585
NPI assigned
Apr 30, 2022
Last updated
Jul 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 25MA13144600 NJ Primary

Addresses

Primary practice location

1 Seymour St FL 6
Montclair, NJ 07042-3771

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230717002270 CO Order and Referring Only - DermatologyPractitioner - Dermatology 3173983541

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
State University of Ny Upstate Medical University, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

150 Floral Ave
New Providence, NJ 07974-1557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1651276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1629713094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SEYMOUR ST FL 6",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423771",
            "telephone_number": "973-302-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "JUAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-30",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA13144600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

Verify at the official NPI Registry.