Individual provider Active NPI

Jorge Agustin Pardo, APN

  • Adult Health Nurse Practitioner
  • Union City, NJ
National Provider Identifier
1871289520
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ01469600 Issued in NJ
Practice address
408 37TH St
Union City, NJ 07087-4994
Phone
(201) 864-4477
NPI assigned
Apr 14, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 26NJ01469600 NJ
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 26NJ01469600 NJ
Adult Health Nurse Practitioner 363LA2200X 26NJ01469600 NJ Primary

Addresses

Primary practice location

408 37TH St
Union City, NJ 07087-4994

Mailing address

3 University PLZ Ste 205
Hackensack, NJ 07601-6208

Other practice location 1

718 Teaneck Rd
Teaneck, NJ 07666-4245
Phone (201) 397-5757

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
I20230518000233 NJ Practitioner - Nurse Practitioner 3577929512 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
Excelcare Medical Associates PAGroup PAC ID 4284647868, 200 clinicians

Practice addresses (Care Compare)

408 37TH St
Union City, NJ 07087-4994
Phone (201) 864-4477

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NJ01469600NJMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Excelcare Medical Associates, PA CurrentSince May 1, 2023 Accepting new patients

Locations

3 University Plz
Ste 205
Hackensack, NJ 07601

1 W Ridgewood Ave
Ste 203
Paramus, NJ 07652
Phone (201) 312-5243

718 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 833-3232

Organizations & group practices 1

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 3

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": "1681430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1871289520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 UNIVERSITY PLZ STE 205",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 37TH ST",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070874994",
            "telephone_number": "201-864-4477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "718 Teaneck Rd",
            "address_purpose": "LOCATION",
            "city": "Teaneck",
            "state": "NJ",
            "postal_code": "076664245",
            "country_code": "US",
            "telephone_number": "201-397-5757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARDO",
        "first_name": "JORGE",
        "middle_name": "AGUSTIN",
        "name_prefix": "Mr.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-14",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "26NJ01469600",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "26NJ01469600",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ01469600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, NJ

Sources for this page

Verify at the official NPI Registry.