MARYJO AGOSTA – Physician Assistant, NPI 1083067722

MARYJO AGOSTA is a healthcare provider. based in Chatham, New Jersey. specializing in PHYSICIAN ASSISTANT. They hold a License No. 25MP00403100 (NJ). The NPI Number for MARYJO AGOSTA is 1083067722

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
MARYJO AGOSTA
NPI
1083067722
Phone
Not provided
Address
30 ROOSEVELT AVE
Enumeration Date
18 July 2016
Last Update Date
18 July 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9084023338
Graduation Year
2016 (10 years ago)
PAC ID
1951699370
Group Practice PAC ID
4082979166
Professional Enrollment ID
I20161018000111
Address ID
NJ079742901NE1286XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:9State licenses:1Digital endpointsOther names

3,578 PHYSICIAN ASSISTANT in NJ

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Provider Addresses for MARYJO AGOSTA

  • 30, Roosevelt Avenue, Chatham, Morris County, New Jersey, 07928, United States

    CHATHAM, NJ 079282548

    Phone:

    Type: Mailing

  • Overlook Emergency Services – Union Campus, 1000, Galloping Hill Road, Roselle Park, Union, Union County, New Jersey, 07083, United States

    UNION, NJ 070837989

    Phone: (908) 522-6300

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-10-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20161018000111IPhysician AssistantNJTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 07928)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082979166View full group profile
NameSpecialtyState
P O D I A T R YNJ
Nurse PractitionerCA
Nurse PractitionerMN
Nurse PractitionerNJ
Physician AssistantNC
Internal MedicineNJ
O B S T E T R I C S/ G Y N E C O L O G YNJ
N E U R O L O G YNJ
Physician AssistantNJ
Emergency Medicine, Internal MedicineNJ

Reviews

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Frequently asked questions

Can I cross-check MARYJO AGOSTA using NPI 1083067722?
NPI 1083067722 belongs to MARYJO AGOSTA; compare other details if you need extra assurance.
Active or inactive — what applies to MARYJO AGOSTA?
You should see MARYJO AGOSTA as active in CMS-hosted NPPES data.
How would a patient describe MARYJO AGOSTA's focus?
For MARYJO AGOSTA, the primary taxonomy reads as Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with MARYJO AGOSTA?
Directory geography for MARYJO AGOSTA centers on Chatham, New Jersey.
Does MARYJO AGOSTA accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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