Individual provider Active NPI

Jessica I Petilla-Onorato, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Morristown, NJ
National Provider Identifier
1720071541
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
25MA06863700 Issued in NJ
Practice address
435 South St
Suite 390
Morristown, NJ 07960-6422
Phone
(973) 971-7022
Fax
(973) 290-7046
NPI assigned
Aug 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 209121 NY
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 25MA06863700 NJ Primary

Addresses

Primary practice location

435 South St
Suite 390
Morristown, NJ 07960-6422

Mailing address

PO Box 416457
Boston, MA 02241-6457
Phone (973) 971-4179

Other identifiers 1

IdentifierTypeStateIssuer
02648295MedicaidNY

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160420001822 NJ Practitioner - Internal MedicinePractitioner - Geriatric Medicine 8224082649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

Hospital & facility affiliations

  • Atlantic Visiting Nurse Home health agency, Morristown, NJ, CCN 317054
  • Atlantic Visiting Nurse Hospice, Morristown, NJ, CCN 311503
  • Morristown Medical Center Hospital, Morristown, NJ, CCN 310015
  • Overlook Medical Center Hospital, Summit, NJ, CCN 310051
  • Chilton Medical Center Hospital, Pompton Plains, NJ, CCN 310017

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209121NYMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group CurrentSince Mar 14, 2016 Accepting new patients

Locations

435 South St
Ste 210
Morristown, NJ 07960
Phone (973) 971-6700

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

435 South St
Ste 390
Morristown, NJ 07960
Phone (973) 971-4656

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

Organizations & group practices 1

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1720071541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "973-971-4179",
            "fax_number": "973-971-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 SOUTH ST",
            "address_2": "SUITE 390",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606422",
            "telephone_number": "973-971-7022",
            "fax_number": "973-290-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETILLA-ONORATO",
        "first_name": "JESSICA",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "209121",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA06863700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02648295",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

Verify at the official NPI Registry.