Active NPI
Miosoty I Desueza, FNP
- Family Nurse Practitioner
- Paterson, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 26NJ14924700
- Practice address
- 416 Park Ave
Paterson, NJ 07504-1989 - Phone
- (973) 684-8138
- NPI assigned
- Oct 23, 2023
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 26NJ14924700 | NJ | Primary |
Addresses
Primary practice location
416 Park Ave
Paterson, NJ 07504-1989
Mailing address
110 Illinois Ave
Paterson, NJ 07503-1637
Phone (973) 801-1143
Other practice location 1
22-18 Broadway
Fair Lawn, NJ 07410-3016
Phone (201) 475-5050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0961621 | Medicaid | NJ |
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
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
416 Park Ave
Paterson, NJ 07504-1989
Phone (973) 684-8138
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.09 of 100
- Quality
- 86.89
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ14924700 | NJ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centro Medico Iberoamericano Inc. | Current | Accepting new patients | |
| Medical Associates of Englewood, PC | Current | Accepting new patients | |
| Eye Care Associates of New Jersey, PA | Past | Accepting new patients |
Locations
1 Broadway
Ste 404
Elmwood Park, NJ 07407
Phone (201) 797-5100
350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073
180 Engle St
Englewood, NJ 07631
Phone (201) 567-2050
22-18 Broadway
Fair Lawn, NJ 07410
Phone (973) 475-5050
22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016
24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123
30 Montgomery St
Ste 720
Jersey City, NJ 07302
Phone (212) 524-7730
Interoperability endpoints
- mramos327112@direct.englewoodhealth.org
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Englewood, NJ
- NPI 1952681918
-
- Internal Medicine Physician
- Paterson, NJ
- NPI 1255520482
-
- Ophthalmology Physician
- Elmwood Park, NJ
- NPI 1063567790
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Englewood, NJ
- NPI 1083612881
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773792000000",
"number": "1831961010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 ILLINOIS AVE",
"city": "PATERSON",
"state": "NJ",
"postal_code": "075031637",
"telephone_number": "973-801-1143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416 PARK AVE",
"city": "PATERSON",
"state": "NJ",
"postal_code": "075041989",
"telephone_number": "973-684-8138"
}
],
"practiceLocations": [
{
"address_1": "22-18 Broadway",
"address_purpose": "LOCATION",
"city": "Fair Lawn",
"state": "NJ",
"postal_code": "074103016",
"country_code": "US",
"telephone_number": "201-475-5050",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DESUEZA",
"first_name": "MIOSOTY",
"middle_name": "I",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-23",
"last_updated": "2026-03-18",
"certification_date": "2026-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NJ",
"license": "26NJ14924700",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0961621",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Paterson, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.