Individual provider Active NPI

Jagoda Roksana Jedrzejek, PA-C

  • Physician Assistant
  • Bayonne, NJ
National Provider Identifier
1891585477
Registry record updated Aug 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
622 Broadway
Bayonne, NJ 07002-3821
Phone
(201) 436-2800
NPI assigned
May 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2026

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 Primary

Addresses

Primary practice location

622 Broadway
Bayonne, NJ 07002-3821

Mailing address

622 Broadway
Bayonne, NJ 07002-3821

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
I20251126002108 NJ Practitioner - Physician Assistant 2062904972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Drexel University College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dominick Condo, MD PAGroup PAC ID 5890689871, 4 clinicians

Practice addresses (Care Compare)

622 Broadway
Bayonne, NJ 07002-3821
Phone (201) 436-2800

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dominick Condo, MD PA CurrentSince Oct 6, 2025 Accepting new patients
Dominick Condo MD PA PastSince Oct 6, 2025 Accepting new patients
Alex Shteynshlyuger MD PC PastSince May 11, 2025 Accepting new patients

Locations

622 Broadway
Bayonne, NJ 07002
Phone (201) 436-2800

Organizations & group practices 3

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": "1746662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787443200000",
    "number": "1891585477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023821",
            "telephone_number": "201-436-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEDRZEJEK",
        "first_name": "JAGODA",
        "middle_name": "ROKSANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-08",
        "last_updated": "2026-08-23",
        "certification_date": "2026-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

Verify at the official NPI Registry.