Individual provider Active NPI

Juan L. Riestra, M.D.

  • Geriatric Psychiatry Physician
  • Wayne, NJ
National Provider Identifier
1841255320
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
25MA05785800 Issued in NJ
Practice address
220 Hamburg Tpke Ste 1
Wayne, NJ 07470-2132
Phone
(973) 389-6020
Fax
(973) 389-6023
NPI assigned
Apr 19, 2006
Last updated
Jul 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X 25MA05785800 NJ Primary

Addresses

Primary practice location

220 Hamburg Tpke Ste 1
Wayne, NJ 07470-2132

Mailing address

1 Rubino Rd
West Caldwell, NJ 07006-8033
Phone (973) 985-1698

Other identifiers 1

IdentifierTypeStateIssuer
7886802MedicaidNJ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100820000622 NJ Practitioner - Psychiatry 9234263625 Reassigns benefits to 3 organizations
Practice locations: Montclair, NJ

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
JS Weill Medical College, Cornell University, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MPV New Jersey MD Services PCGroup PAC ID 5991097669, 146 clinicians
St Josephs Healthcare IncGroup PAC ID 9739171984, 21 clinicians
St Josephs Medical Group PCGroup PAC ID 8628470325, 217 clinicians

Practice addresses (Care Compare)

1 Bay Ave
Montclair, NJ 07042-4837
Phone (201) 781-1387

220 Hamburg Tpke
Suite 4
Wayne, NJ 07470-2132
Phone (973) 389-6022

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-6331

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA05785800NJMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Medical Group PC CurrentSince Nov 2, 2021 Accepting new patients
MPV New Jersey MD Services PC CurrentSince Apr 1, 2024 Accepting new patients
St. Joseph's Healthcare, Inc. CurrentSince Jul 8, 2019 Accepting new patients
MPV New Jersey MD Services PC CurrentSince Apr 1, 2024 Accepting new patients
St Josephs University Medical Center Inc. PastSince Jul 8, 2019 Accepting new patients
Montclair Hospital LLC Past Accepting new patients

Locations

1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100

30 W Century Rd
Paramus, NJ 07652
Phone (201) 261-2000

641 Main St
Paterson, NJ 07503
Phone (973) 754-2575

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

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

703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240

220 Hamburg Tpke
Ste 1
Wayne, NJ 07470
Phone (973) 904-0404

220 Hamburg Tpke
Ste 4
Wayne, NJ 07470
Phone (973) 389-6022

Interoperability endpoints

  • Direct secure messaging: jriestra@sjhbh.cernerdirect.com
  • Direct secure messaging: jriestra191605@ahs.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1841255320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RUBINO RD",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070068033",
            "telephone_number": "973-985-1698",
            "fax_number": "973-439-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 HAMBURG TPKE STE 1",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702132",
            "telephone_number": "973-389-6020",
            "fax_number": "973-389-6023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIESTRA",
        "first_name": "JUAN",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NJ",
            "license": "25MA05785800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7886802",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.