Individual provider Active NPI

Christa Milici, PA

  • Physician Assistant
  • Montclair, NJ
National Provider Identifier
1861974115
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00484400 Issued in NJ
Practice address
1 Bay Ave Ste 3
Montclair, NJ 07042-4837
Phone
(973) 820-3470
NPI assigned
Sep 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00484400 NJ Primary

Addresses

Primary practice location

1 Bay Ave Ste 3
Montclair, NJ 07042-4837

Mailing address

1 Bay Ave Ste 3
Montclair, NJ 07042-4837
Phone (973) 820-3470

Other practice location 1

101 Old Short Hills Rd Ste 302
West Orange, NJ 07052-1023
Phone (973) 322-6757

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
I20190221000029 NJ Practitioner - Physician Assistant 2365780129 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MPV New Jersey MD Services PC CurrentSince Mar 22, 2022 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Dec 31, 2018 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Dec 31, 2018 Accepting new patients

Locations

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

1 Bay Ave
Ste 3
Montclair, NJ 07042
Phone (201) 490-4333

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

101 Old Short Hills Rd
Ste 302
West Orange, NJ 07052
Phone (973) 322-6200

Interoperability endpoints

  • Direct secure messaging: cmilici559635@ahs.direct-ci.com

Organizations & group practices 5

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": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1861974115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAY AVE STE 3",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424837",
            "telephone_number": "973-820-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAY AVE STE 3",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424837",
            "telephone_number": "973-820-3470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Old Short Hills Rd Ste 302",
            "address_purpose": "LOCATION",
            "city": "West Orange",
            "state": "NJ",
            "postal_code": "070521023",
            "country_code": "US",
            "telephone_number": "973-322-6757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILICI",
        "first_name": "CHRISTA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00484400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

Verify at the official NPI Registry.