Individual provider Active NPI

Hernan Feliciano, P.A.

  • Physician Assistant
  • Newark, NJ
National Provider Identifier
1750590451
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005884 Issued in NY
Practice address
150 Bergen St
Newark, NJ 07103-2496
Phone
(973) 972-6680
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 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 25MP00102600 NJ
Physician Assistant 363A00000X 005884 NY Primary

Addresses

Primary practice location

150 Bergen St
Newark, NJ 07103-2496

Mailing address

8 Tralee Rd
Hazlet, NJ 07730-1148
Phone (732) 888-3671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
005884NYMDPhysical Therapy Assistant
25MP00102600NJMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1750590451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 TRALEE RD",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301148",
            "telephone_number": "732-888-3671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELICIANO",
        "first_name": "HERNAN",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00102600",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.