Individual provider Active NPI

Lori Heather Attanasio, PA-C

  • Medical Physician Assistant
  • Parsippany, NJ
National Provider Identifier
1962558585
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00235700 Issued in NJ
Practice address
200 Reynolds Ave
Parsippany, NJ 07054-3326
Phone
(973) 887-8080
Fax
(610) 612-5483
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 2205 MA
Medical Physician Assistant 363AM0700X 25MP00235700 NJ Primary

Addresses

Primary practice location

200 Reynolds Ave
Parsippany, NJ 07054-3326

Mailing address

200 Reynolds Ave
Parsippany, NJ 07054-3326
Phone (973) 887-8080

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
I20210216000123 NJ Practitioner - Physician Assistant 3971918467 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MP00235700NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fellowship Village Inc. CurrentSince Dec 18, 2024 Accepting new patients

Locations

8000 Fellowship Rd
Basking Ridge, NJ 07920
Phone (908) 580-3800

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.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1962558585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 REYNOLDS AVE",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070543326",
            "telephone_number": "973-887-8080",
            "fax_number": "610-612-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 REYNOLDS AVE",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070543326",
            "telephone_number": "973-887-8080",
            "fax_number": "610-612-5483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTANASIO",
        "first_name": "LORI",
        "middle_name": "HEATHER",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "2205",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00235700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parsippany, NJ

Sources for this page

Verify at the official NPI Registry.