Lydia Pan, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

308 Willow Ave
Hoboken, NJ 07030-3808

Phone

(626) 456-2358

NPI assigned

May 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, CA2 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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Doa Professional CorporationGroup PAC ID 0042661969, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lydia.pan.1@25843.direct.athenahealth.com

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.

• Doa Professional Corporation

  • General Practice Physician
  • Santa Clarita, CA
  • NPI 1073399804
  Medicare reassignment Care Compare group
• Friendly Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Teaneck, NJ
  • NPI 1255843876
  Medicare reassignment NPD
• Garden State Healthcare Associates, LLC

  • Emergency Medicine Physician
  • Bayonne, NJ
  • NPI 1700014545
  Medicare reassignment
• Ihpnj ER LLC

  • Emergency Medicine Physician
  • Hoboken, NJ
  • NPI 1225750946
  Medicare reassignment
• SKR Medical Advisors

  • Urgent Care Clinic/Center
  • Lyndhurst, NJ
  • NPI 1184971558
  Medicare reassignment
• The Radiology Group of New Jersey, LLC

  • Multi-Specialty Clinic/Center
  • Hackettstown, NJ
  • NPI 1174010540
  NPD (past)

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

{
    "created_epoch": "1557446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1821654336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 SCHINDLER DR",
            "city": "ABERDEEN",
            "state": "NJ",
            "postal_code": "077473752",
            "telephone_number": "626-456-2358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 WILLOW AVE",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070303808",
            "telephone_number": "626-456-2358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2570 48th St",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958171541",
            "country_code": "US",
            "telephone_number": "916-734-2145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAN",
        "first_name": "LYDIA",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-10",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlysa Oyama, MD
• Ashley Meredith Pagelow, MA CCC-SLP
• Meera Paghdal, PHARMACIST
• Bianca Palestis
• Shelley Palumbo, D.P.T
• Tai Pan, MD
• Adrienne Pannullo
• Ashley Papa
• Lauren Papaianni, M.A.
• Ruchita Parekh, MD

• Physician Assistant in Hoboken, NJ
• Providers in Hoboken, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2019; 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.

Verify at the official NPI Registry.