Active NPI
Jacqueline Bancroft, PA-C
- Physician Assistant
- Newark, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 25MP00366200
- Practice address
- 201 Lyons Ave
Newark, NJ 07112-2027 - Phone
- (973) 926-3500
- NPI assigned
- Jun 16, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00366200 | NJ | Primary |
Addresses
Primary practice location
201 Lyons Ave
Newark, NJ 07112-2027
Mailing address
1 Farmington CT
Bordentown, NJ 08505-3183
Phone (609) 462-9915
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
201 Lyons Ave
Newark, NJ 07112-2027
94 Old Short Hills Rd
Livingston, NJ 07039-5672
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00366200 | NJ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barnabas Health Medical Group PC | Current | Accepting new patients | |
| Barnabas Health Medical Group PC | Current | Accepting new patients |
Locations
475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000
94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400
201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455
166 Lyons Ave
Newark, NJ 07112
Phone (973) 926-7300
379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545
Interoperability endpoints
- jbancroft229781@epicdirect.rwjbh.org
Organizations & group practices 2
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.
-
- Specialist
- Elizabeth, NJ
- NPI 1841557246
-
- Durable Medical Equipment & Medical Supplies
- Hackensack, NJ
- NPI 1316772668
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Newark, NJ
- NPI 1215027966
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1821479742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 FARMINGTON CT",
"city": "BORDENTOWN",
"state": "NJ",
"postal_code": "085053183",
"telephone_number": "609-462-9915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 LYONS AVE",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071122027",
"telephone_number": "973-926-3500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANCROFT",
"first_name": "JACQUELINE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-16",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00366200",
"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 Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.