Individual provider Active NPI

Patricia PO, APN

  • Acute Care Nurse Practitioner
  • Wayne, NJ
National Provider Identifier
1831808781
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
26NJ01391600 Issued in NJ
Practice address
224 Hamburg Tpke
Wayne, NJ 07470-2168
Phone
(973) 942-6900
NPI assigned
Nov 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X F432352 NY
Adult Health Nurse Practitioner 363LA2200X 26NJ01391600 NJ
Gerontology Nurse Practitioner 363LG0600X 26NJ01391600 NJ
Acute Care Nurse Practitioner 363LA2100X 26NJ01391600 NJ Primary

Addresses

Primary practice location

224 Hamburg Tpke
Wayne, NJ 07470-2168

Mailing address

536 Clifton Ave
Clifton, NJ 07011-3277
Phone (818) 572-6728

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230126000804 NJ Practitioner - Nurse Practitioner 8527439702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical Group PCGroup PAC ID 8628470325, 217 clinicians

Practice addresses (Care Compare)

224 Hamburg Tpke
Wayne, NJ 07470-2168
Phone (973) 569-6118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F432352NYMDAcute Care Nurse Practitioner
26NJ01391600NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Medical Group PC CurrentSince Dec 27, 2022 Accepting new patients

Locations

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

Organizations & group practices 1

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": "1668729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1831808781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070113277",
            "telephone_number": "818-572-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 HAMBURG TPKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702168",
            "telephone_number": "973-942-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PO",
        "first_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-18",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "F432352",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ01391600",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NJ01391600",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NJ",
            "license": "26NJ01391600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.