Individual provider Active NPI

Myriam N Paredes

  • Nurse Practitioner
  • Fords, NJ
National Provider Identifier
1649863028
Registry record updated Mar 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ01092100 Issued in NJ
Practice address
408 New Brunswick Ave
Fords, NJ 08863-2110
Phone
(732) 688-8751
NPI assigned
Feb 16, 2021
Last updated
Mar 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 26NJ01092100 NJ Primary

Addresses

Primary practice location

408 New Brunswick Ave
Fords, NJ 08863-2110

Mailing address

14 Exeter St
Old Bridge, NJ 08857-2202
Phone (732) 688-8751

Other practice location 1

45 Pearl street
Norht Plaifield, NJ 07060-1166
Phone (732) 688-8751

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20211001001481 NJ Practitioner - Nurse Practitioner 9032517255 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ01092100NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Eduardo Samaniego - Primary Medical Care LLC CurrentSince Apr 9, 2022 Accepting new patients
Family Medicine Group LLC PastSince Jun 25, 2021 Accepting new patients

Locations

76 Prospect St
Ste 1
Newark, NJ 07105
Phone (973) 333-4480

165 Mountain Ave
Springfield, NJ 07081
Phone (973) 344-1313

Organizations & group practices 2

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": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742083200000",
    "number": "1649863028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 EXETER ST",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572202",
            "telephone_number": "732-688-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 NEW BRUNSWICK AVE",
            "city": "FORDS",
            "state": "NJ",
            "postal_code": "088632110",
            "telephone_number": "732-688-8751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 Pearl street",
            "address_purpose": "LOCATION",
            "city": "Norht Plaifield",
            "state": "NJ",
            "postal_code": "070601166",
            "country_code": "US",
            "telephone_number": "732-688-8751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAREDES",
        "first_name": "MYRIAM",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2025-03-16",
        "certification_date": "2025-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01092100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fords, NJ

Sources for this page

Verify at the official NPI Registry.