Individual provider Active NPI

Lillianna Angeline Carbone, PA

  • Physician Assistant
  • Atlantic City, NJ
National Provider Identifier
1891531703
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00976500 Issued in NJ
Practice address
1925 Pacific Ave
Atlantic City, NJ 08401-6713
Phone
(609) 441-8023
Fax
(609) 441-8178
NPI assigned
Jul 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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 25MP00976500 NJ Primary

Addresses

Primary practice location

1925 Pacific Ave
Atlantic City, NJ 08401-6713

Mailing address

1925 Pacific Ave
Atlantic City, NJ 08401-6713
Phone (609) 441-8023

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
I20251208000377 NJ Practitioner - Physician Assistant 3577056589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

331 Newman Springs Rd
Red Bank, NJ 07701-5688

Hospital & facility affiliations

  • Atlanticare Regional Medical Center - City Campus Hospital, Atlantic City, NJ, CCN 310064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00976500NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Regional Medical Center CurrentSince Nov 25, 2025 Accepting new patients
Atlanticare Regional Medical Center CurrentSince Nov 25, 2025 Accepting new patients

Locations

1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

Organizations & group practices 2

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": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1891531703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 PACIFIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016713",
            "telephone_number": "609-441-8023",
            "fax_number": "609-441-8178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 PACIFIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016713",
            "telephone_number": "609-441-8023",
            "fax_number": "609-441-8178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBONE",
        "first_name": "LILLIANNA",
        "middle_name": "ANGELINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00976500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic City, NJ

Sources for this page

Verify at the official NPI Registry.