Adrianna C Baccaro
Individual provider Active NPI Surgical Physician Assistant · Florham Park, NJ
NPI 1649954744 · NPPES record last updated Sep 13, 2023
Key facts
- NPI
- 1649954744
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 25MP00790400 (NJ)
- Practice address
- 150 Park Ave
Florham Park, NJ 07932-1049 - Phone
- (973) 718-5800
- Fax
- (973) 939-4216
- NPI assigned
- Jun 9, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 25
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Summit Medical Group PA
Practice addresses (Care Compare)
1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300
Hospital & facility affiliations
- Overlook Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231016003439 | NJ | Practitioner - Physician Assistant | 8123473832 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00790400 | NJ | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group PA | Current |
Accepting new patients | |
| Summit Medical Group PA | Current |
Accepting new patients | |
| Summit Medical Group, Inc | Physician Assistant | Past | Accepting new patients |
Locations
1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868
630 Commons Way
Bridgewater, NJ 08807
Phone (908) 603-8697
140 Park Ave
Florham Park, NJ 07932
Phone (973) 285-7613
150 Park Ave
Florham Park, NJ 07932
Phone (973) 404-9980
150 Floral Ave
New Providence, NJ 07974
Phone (908) 588-3890
Interoperability endpoints
- adrianna.baccaro.1@2983.direct.athenahealth.com
- abaccaro508303@direct.ahsys.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Surgical Physician Assistant | 363AS0400X | 25MP00790400 | NJ | Yes |
Addresses
Primary practice location
150 Park Ave
Florham Park, NJ 07932-1049
Mailing address
37 Minnisink Rd
Totowa, NJ 07512-1927
Phone (973) 897-2622
Other providers in Florham Park, NJ
- Associates in Internal Medicine LLC
- Atlantic Neurocare LLC
- Atlantic Orthopaedic Associates, LLC
- Atrium Medical Group
- Jocelyn Christina Avila
- Karen Elizabeth Baddoura
- Caryn Beth Badian
- James J Bae
- Bai Li Medical Center
- Bai Li Medical Health Center
All providers in Florham Park, NJ · Surgical Physician Assistant in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.