Individual provider Active NPI

Chelsea Nicole Drake, PA-C

  • Physician Assistant
  • Berkeley Heights, NJ
National Provider Identifier
1740777127
Registry record updated Dec 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00681000 Issued in NJ
Practice address
369 Springfield Ave
Berkeley Heights, NJ 07922-1170
Phone
(908) 464-6700
NPI assigned
Apr 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 55580 CA
Physician Assistant 363A00000X 25MP00681000 NJ Primary

Addresses

Primary practice location

369 Springfield Ave
Berkeley Heights, NJ 07922-1170

Mailing address

369 Springfield Ave
Berkeley Heights, NJ 07922-1170
Phone (908) 464-6700

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
I20220615000162 NJ Practitioner - Physician Assistant 7113277740 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of California, San Francisco School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morristown Emergency Medical Associates LLCGroup PAC ID 7618136078, 82 clinicians
The Medical Group of New JerseyGroup PAC ID 4082979166, 299 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (954) 939-5000

651 Willow Grove St
Hackettstown, NJ 07840-1799
Phone (908) 979-1621

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55580CAMDOrthodontics and Dentofacial Orthopedic Dentist
25MP00681000NJMDPhysician Assistant

Organizations & group practices 5

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 1

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": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671235200000",
    "number": "1740777127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 SPRINGFIELD AVE",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079221170",
            "telephone_number": "908-464-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 SPRINGFIELD AVE",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079221170",
            "telephone_number": "908-464-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "CHELSEA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-20",
        "last_updated": "2022-12-17",
        "certification_date": "2022-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "55580",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00681000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Heights, NJ

Sources for this page

Verify at the official NPI Registry.