Individual provider Active NPI

John Saldarriaga, PA-C

  • Medical Physician Assistant
  • Paterson, NJ
National Provider Identifier
1831829027
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00707100 Issued in NJ
Practice address
91 Main St
Paterson, NJ 07505-1026
Phone
(973) 523-4000
NPI assigned
Jun 13, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Medical Physician Assistant 363AM0700X 25MP00707100 NJ Primary

Addresses

Primary practice location

91 Main St
Paterson, NJ 07505-1026

Mailing address

91 Main St
Paterson, NJ 07505-1026

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
I20220728002028 NJ Practitioner - Physician Assistant 6709268386 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakewood Resource and Referral Center IncGroup PAC ID 6901981497, shared by 5 NPIs, 106 clinicians
BP Immediate Medical Care, PCGroup PAC ID 8628295581, 25 clinicians

Practice addresses (Care Compare)

1771 Madison Ave
Lakewood, NJ 08701-1251

555 W Side Ave
Chai Jersey City
Jersey City, NJ 07304-1617
Phone (201) 688-2424

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00707100NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Friendly Urgent Care, LLC Past Accepting new patients

Organizations & group practices 4

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": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1831829027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075051026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075051026",
            "telephone_number": "973-523-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALDARRIAGA",
        "first_name": "JOHN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-07-06",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00707100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.