MEDICARE: EVERSIDE HEALTH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1558229138
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERSIDE HEALTH, LLC

Provider Business Mailing Address
First Line	:	100 TOWN SQUARE PL STE 630
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07310-2778
Country	:	US
Telephone Number	:	973-685-5809
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 TOWN SQUARE PL STE 630
Second Line	:	STE 630
City	:	JERSEY CITY
State	:	NJ
Zip	:	07310-2778
Country	:	US
Telephone Number	:	973-685-5809
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF RISK MANAGEMENT
Name	:	MELISSA PAGAN
Credential	:
Telephone Number	:	201-450-8974

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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Directions to “EVERSIDE HEALTH, LLC ” Practice Location

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