Nicole Jones, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00974900 Issued in NJ

Practice address

12 Roland Rd
Pequannock, NJ 07440-1909

Phone

(973) 980-0094

NPI assigned

Oct 28, 2025

Sex

Female

Sole proprietor

No

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

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Am PM Walk in Urgent Care ClinicGroup PAC ID 5092954602, 79 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Am PM Walk in Urgent Care Clinic

  • Urgent Care Clinic/Center
  • Bergenfield, NJ
  • NPI 1073853859
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1761609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1962370163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 ROLAND RD",
            "city": "PEQUANNOCK",
            "state": "NJ",
            "postal_code": "074401909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ROLAND RD",
            "city": "PEQUANNOCK",
            "state": "NJ",
            "postal_code": "074401909",
            "telephone_number": "973-980-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-28",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00974900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neeta Gupta, CCC-SLP
• Kristen Hanisch, LCSW
• Celina Jannicelli, FNP
• Dariusz Jasinski, DPM
• Jersey Care Ambulance Services Inc
• Pawanjeet Kaur
• Brian Knowles
• Nour A Kwaik, PHARMD
• Michael Louro, LCSW
• Antoinette Martin, REGISTERED NURSE

• Physician Assistant in Pequannock, NJ
• Providers in Pequannock, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; 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.