Individual provider Active NPI

Miosoty I Desueza, FNP

  • Family Nurse Practitioner
  • Paterson, NJ
National Provider Identifier
1831961010
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ14924700 Issued in NJ
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

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0961621MedicaidNJ

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
I20231219001592 NJ Practitioner - Nurse Practitioner 8426408360 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
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

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 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ14924700NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico Iberoamericano Inc. CurrentSince Dec 1, 2023 Accepting new patients
Medical Associates of Englewood, PC CurrentSince Dec 1, 2023 Accepting new patients
Eye Care Associates of New Jersey, PA PastSince Jun 13, 2008 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

  • Direct secure messaging: 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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.