Individual provider Active NPI

John J Messina, M.D

  • Specialist
  • Elmwood Park, NJ
National Provider Identifier
1922186311
Registry record updated May 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MA05366500 Issued in NJ
Practice address
1 Broadway
Suite 203
Elmwood Park, NJ 07407-1842
Phone
(972) 569-6250
Fax
(973) 569-6270
NPI assigned
Nov 1, 2006
Last updated
May 2, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MA05366500 NJ Primary
Pediatric Cardiology Physician 2080P0202X 25MA05366500 NJ

Addresses

Primary practice location

1 Broadway
Suite 203
Elmwood Park, NJ 07407-1842

Mailing address

1 Broadway
Suite 203
Elmwood Park, NJ 07407-1842
Phone (972) 569-6250

Other identifiers 1

IdentifierTypeStateIssuer
5152101MedicaidNJ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040423000160 NJ Practitioner - Pediatric Medicine 6709872872 Reassigns benefits to 2 organizations
Practice locations: Paterson, NJ

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Cardiology Associates PCGroup PAC ID 5799768875, 3 clinicians

Practice addresses (Care Compare)

1 Broadway
Suite 203
Elmwood Park, NJ 07407-1844
Phone (973) 569-6250

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA05366500NJMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Medical Group PC CurrentSince Aug 1, 2023 Accepting new patients
Pediatric Cardiology Associates PC Specialist CurrentSince Jul 1, 1992 Accepting new patients
St Josephs University Medical Center Inc. Past Accepting new patients

Locations

1 Broadway
Ste 203
Elmwood Park, NJ 07407
Phone (973) 569-6250

11 Getty Ave
Paterson, NJ 07503
Phone (973) 754-4200

11 Getty Ave
Paterson, NJ 07503

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

220 Hamburg Tpke
Ste 203
Wayne, NJ 07470

Interoperability endpoints

  • Direct secure messaging: john.messina@pedcard.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493683200000",
    "number": "1922186311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BROADWAY",
            "address_2": "SUITE 203",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074071842",
            "telephone_number": "972-569-6250",
            "fax_number": "973-569-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROADWAY",
            "address_2": "SUITE 203",
            "city": "ELMWOOD PARK",
            "state": "NJ",
            "postal_code": "074071842",
            "telephone_number": "972-569-6250",
            "fax_number": "973-569-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESSINA",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2017-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA05366500",
            "primary": true
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NJ",
            "license": "25MA05366500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5152101",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmwood Park, NJ

Sources for this page

Verify at the official NPI Registry.