Individual provider Active NPI

Kevin Jaramillo, PAC

  • Medical Physician Assistant
  • Englewood, NJ
National Provider Identifier
1790459816
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2745644 Issued in NY
Practice address
39 Parkview Ter Apt 39
Englewood, NJ 07631-4214
Phone
(201) 674-8415
NPI assigned
Aug 3, 2021
Last updated
Aug 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X 25MP00760900 NJ
Medical Physician Assistant 363AM0700X 2745644 NY Primary

Addresses

Primary practice location

39 Parkview Ter Apt 39
Englewood, NJ 07631-4214

Mailing address

16-12 Far Rockaway Blvd
Far Rockaway, NY 11691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ, NY3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20211007003249 PA Practitioner - Physician Assistant 0042618803 Reassigns benefits to 1 organization
I20230407000898 NJ Practitioner - Physician Assistant 0042618803 Reassigns benefits to 2 organizations
I20260417002704 NY Practitioner - Physician Assistant 0042618803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hackensack Meridian Urgent Care PCGroup PAC ID 2769751270, 50 clinicians
Vantage Medical Associates PCGroup PAC ID 0547673816, 84 clinicians
Am PM Walk in Urgent Care ClinicGroup PAC ID 5092954602, 79 clinicians

Practice addresses (Care Compare)

1080 Stelton Rd
Piscataway, NJ 08854-5201
Phone (848) 230-6802

1612 Central Ave
Suite 201
Far Rockaway, NY 11691-4002
Phone (516) 792-1600

19 S Washington Ave
Bergenfield, NJ 07621-2324
Phone (201) 387-0177

49 W Allendale Ave
Suite 4
Allendale, NJ 07401-1755
Phone (201) 340-6052

521 Livingston St
Suite 116
Norwood, NJ 07648-1358
Phone (201) 267-6600

587 Cedar Lane
Teaneck, NJ 07666-1701
Phone (201) 387-0177

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Am PM Walk in Urgent Care Clinic CurrentSince Jan 10, 2026 Accepting new patients
St. Luke's Physician Group, Inc. CurrentSince Oct 25, 2021 Accepting new patients
St Luke's Physician Group Inc CurrentSince Oct 25, 2021 Accepting new patients
Am PM Primary Care Past Accepting new patients
Northern Ohio Medical Specialists, LLC Past Accepting new patients

Locations

19 S Washington Ave
Bergenfield, NJ 07621
Phone (201) 387-0177

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Interoperability endpoints

  • Direct secure messaging: kevin.jaramillo@slpg.direct-sluhn.org

Organizations & group practices 8

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

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": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1790459816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16-12 FAR ROCKAWAY BLVD",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "11691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 PARKVIEW TER APT 39",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314214",
            "telephone_number": "201-674-8415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARAMILLO",
        "first_name": "KEVIN",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-03",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00760900",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "2745644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.