Regina Patrick

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ151182400 Issued in NJ

Practice address

1 Bay Ave
Montclair, NJ 07042-4837

Phone

(973) 429-6000

NPI assigned

Oct 29, 2024

Last updated

Oct 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rpickens189152@ahs.direct-ci.com

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.

• Montclair Hospital LLC

  dba Montclair Multi Speciality Health Center

  • Specialist
  • Montclair, NJ
  • NPI 1093095184
  Medicare reassignment NPD
• Montclair Hospital LLC

  dba HackensackUMC Mountainside

  • General Acute Care Hospital
  • Montclair, NJ
  • NPI 1982720249
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1891517942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 SEAPORT DR",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072013385",
            "telephone_number": "973-444-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAY AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424837",
            "telephone_number": "973-429-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "REGINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ151182400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pathmark Stores Inc (Pathmark Pharmacy)
• Patience Moore, LCSW, LLC
• Patient Centered Medical Associates, PA
• Patient Friendly Specialty Pharmacy -PFSP
• Lydia Ann Patrick-Deluca, MSN RN APN-C
• Caitlyn Pawlek
• Lisa Pedi, M.S., CCC-SLP
• Joseph Peter Pedoto, PH.D.
• Brittany Peery, LCSW
• Marcela Pekarova, NP

• Family Nurse Practitioner in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.

Verify at the official NPI Registry.