Individual provider Active NPI

Winslow Percival Braithwaite, PA

  • Surgical Physician Assistant
  • West Orange, NJ
National Provider Identifier
1750301115
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
25MP00046300 Issued in NJ
Practice address
81 Northfield Ave Ste 304
West Orange, NJ 07052-5344
Phone
(973) 612-2214
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 003950 NY
Surgical Physician Assistant 363AS0400X 25MP00046300 NJ Primary

Addresses

Primary practice location

81 Northfield Ave Ste 304
West Orange, NJ 07052-5344

Mailing address

1320 Adams St Ste de
Hoboken, NJ 07030-2370
Phone (201) 308-6622

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
I20050829000193 NJ Practitioner - Physician Assistant 8426089566 Reassigns benefits to 2 organizations
I20151204000027 NY Practitioner - Physician Assistant 8426089566 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00046300NJMDSurgical Physician Assistant
003950NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
TBHC Physician Services PC CurrentSince Jan 20, 2026 Accepting new patients
Hudson Pro Orthopaedics and Sports Medicine CurrentSince Jan 1, 2026 Accepting new patients
Hudson Orthopedics PLLC CurrentSince Jan 1, 2026 Accepting new patients
Sovereign Medical Group LLC Past Accepting new patients
New York Metropolitan Orthopaedics and Spine, LLC PastSince Sep 1, 2021 Accepting new patients

Locations

1320 Adams St
Ste De
Hoboken, NJ 07030
Phone (201) 241-2044

86 Saint Felix St
Fl 10
Brooklyn, NY 11217
Phone (718) 250-8103

121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604

143 W 29th St
Fl 5
New York, NY 10001
Phone (646) 650-2229

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DJAICA

Organizations & group practices 6

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1750301115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 ADAMS ST STE DE",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070302370",
            "telephone_number": "201-308-6622",
            "fax_number": "201-308-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 NORTHFIELD AVE STE 304",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070525344",
            "telephone_number": "973-612-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAITHWAITE",
        "first_name": "WINSLOW",
        "middle_name": "PERCIVAL",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "003950",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00046300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.