MONTCLAIR BREAST CENTER PC
NPI 1053367334
Surgery in Montclair, NJ
About Montclair Breast Center Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MONTCLAIR BREAST CENTER PC (NPI 1053367334) is a healthcare organization registered as a surgery in Montclair, New Jersey and active in the NPI registry since May 2006. The organization lists Jackie L Hernandez, Billing Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Identifiers 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Montclair Breast Center Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
17Medicare enrollment records show 17 clinicians reassign Medicare billing to Montclair Breast Center PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 7 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 5
Clinicians, nearest first (17)
Montclair, NJ 07042
Montclair, NJ 07042
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Montclair Breast Center PC's NPI number?
The NPI number for Montclair Breast Center PC is 1053367334. It was assigned to this organization in the NPPES registry on May 26, 2006.
Where is Montclair Breast Center PC located?
Montclair Breast Center PC is located at 37 No Fullerton Avenue Montclair Breast Center PC, Montclair, NJ 07042. The listed phone number is (973) 509-1818.
What is Montclair Breast Center PC's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Montclair Breast Center PC enrolled in Medicare?
Yes. Montclair Breast Center PC is registered in the Medicare PECOS enrollment system.
When is Montclair Breast Center PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New Jersey, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Montclair Breast Center PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 17 clinicians in 5 Medicare specialties reassign their Medicare billing to Montclair Breast Center PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Diagnostic Radiology (6), Nurse Practitioner (5) and General Surgery (4). Of these, 3 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Montclair Breast Center PC was last updated on July 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Montclair Breast Center Pc · NPI 1053367334
Surgery organization in Montclair, New Jersey. Organization record, active in the CMS NPPES registry since May 26, 2006.
## Identity
- **NPI:** 1053367334 (Entity type: Organization)
- **Enumerated:** May 26, 2006
- **Primary specialty:** Surgery · taxonomy 208600000X
- **Organization subpart:** No
- **Authorized official:** Jackie Hernandez, BILLING MANAGER
## Practice location
- **Address:** 37 NO FULLERTON AVENUE, MONTCLAIR BREAST CENTER PC, Montclair, NJ 07042-3426
- **Phone:** (973) 509-1818 · **Fax:** (973) 509-0708
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, New Jersey, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 17 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Diagnostic Radiology (6), Nurse Practitioner (5), General Surgery (4); 3 practice at this address and 7 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 9, 2026
- **Other identifiers:** Other 23317 (NJ); Other 126219 (NJ)
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Source: [NPI Profile](https://npiprofile.com/npi/1053367334) · Data from the CMS NPPES public registry.