Individual provider Active NPI

Michelle Valencia

  • Medical Physician Assistant
  • Jersey City, NJ
National Provider Identifier
1720714728
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
355 Grand St
Jersey City, NJ 07302-4321
Phone
(201) 915-2000
NPI assigned
Aug 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

355 Grand St
Jersey City, NJ 07302-4321

Mailing address

104 62ND St Apt 8
West New York, NJ 07093-2929

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
I20230505000847 NJ Practitioner - Physician Assistant 2466817929 Reassigns benefits to 6 organizations
I20251112001949 NY Practitioner - Physician Assistant 2466817929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

125 Mineola Ave
Suite 200
Roslyn Heights, NY 11577-2023

125 Mineola Ave
Suite 200
Roslyn Heights, NY 11577-2042

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
028852NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bergen County Improvement Authority CurrentSince Apr 21, 2023 Accepting new patients
New York Bariatric Surgery Group PLLC CurrentSince Oct 1, 2025 Accepting new patients
Bergen County Improvement Authority CurrentSince Apr 21, 2023 Accepting new patients
Bergen County Improvement Authority Past Accepting new patients

Locations

523 Broadway
Bayonne, NJ 07002
Phone (201) 649-1190

1121 Route 22
Ste 203
Bridgewater, NJ 08807
Phone (908) 237-7412

28 Gibson Blvd
Clark, NJ 07066

98 James St
Ste 103
Edison, NJ 08820
Phone (732) 662-5888

98 James St
Ste 212
Edison, NJ 08820
Phone (732) 548-1800

83 Hanover Rd
Ste 190
Florham Park, NJ 07932
Phone (973) 410-9700

230 Sherman Ave
Fl 2
Glen Ridge, NJ 07028
Phone (973) 750-0104

230 E Ridgewood Ave
Paramus, NJ 07652
Phone (201) 225-4700

1 W Ridgewood Ave
Ste G2
Paramus, NJ 07652
Phone (201) 652-1213

120 Cedar Grove Ln
Ste T14
Somerset, NJ 08873

355 US Highway 22 E
Springfield, NJ 07081
Phone (908) 325-3000

197 Cedar Ln
Ste 2
Teaneck, NJ 07666
Phone (201) 591-9840

1680 State Route 23
Ste 180
Wayne, NJ 07470
Phone (484) 934-1070

340 Broadhollow Rd
Ste 2
Farmingdale, NY 11735

496 County Road 111
Bldg D
Manorville, NY 11949
Phone (631) 405-3200

233 W Route 59
Ste 103
Nanuet, NY 10954

125 Mineola Ave
Ste 200
Roslyn Hts, NY 11577
Phone 5166165500800

Interoperability endpoints

  • Direct secure messaging: mvalencia840812@ahs.direct-ci.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659312000000",
    "number": "1720714728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 62ND ST APT 8",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070932929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 GRAND ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073024321",
            "telephone_number": "201-915-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENCIA",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.