Individual provider Active NPI

Jorge Luis Vivar-Aguirre, M.D.

  • Internal Medicine Physician
  • Englewood, NJ
National Provider Identifier
1003249319
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D80895 Issued in MD
Practice address
350 Engle St
Englewood Hospital-Departament of Medicine
Englewood, NJ 07631-1808
Phone
(201) 984-3664
NPI assigned
Aug 10, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X D80895 MD Primary

Addresses

Primary practice location

350 Engle St
Englewood Hospital-Departament of Medicine
Englewood, NJ 07631-1808

Mailing address

350 Engle St
Englewood Hospital-Departament of Medicine
Englewood, NJ 07631-1808
Phone (201) 984-3664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161004001266 MD Practitioner - Internal Medicine 5799073920 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Practice addresses (Care Compare)

1639 Woodbrooke Dr
Tidalhealth Endocrinology
Salisbury, MD 21804-8502
Phone (410) 572-8848

Hospital & facility affiliations

  • Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019
  • Tidalhealth Nanticoke, Inc. Hospital, Seaford, DE, CCN 080006
  • Atlantic General Hospital Hospital, Berlin, MD, CCN 210061
  • Riverside Shore Memorial Hospital Hospital, Onancock, VA, CCN 490037
  • Beebe Medical Center Hospital, Lewes, DE, CCN 080007

Merit-based Incentive Payment System (MIPS)

Final score
82.92 of 100Reported as group
Quality
74.47
Promoting interoperability
92
Improvement activities
40
Cost
75.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D80895MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Peninsula Regional, Inc. CurrentSince Aug 22, 2016 Accepting new patients
Tidalhealth Peninsula Regional, Inc. Internal Medicine Current Accepting new patients
Tidalhealth Specialty Care, LLC CurrentSince Sep 1, 2020 Accepting new patients
Tidalhealth Peninsula Regional, Inc. CurrentSince Aug 22, 2016 Accepting new patients
Tidalhealth Specialty Care, LLC Past Accepting new patients

Locations

1639 Woodbrooke Dr
Salisbury, MD 21804
Phone (410) 543-7475

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

106 Milford St
Ste 201
Salisbury, MD 21804
Phone (410) 543-1616

145 E Carroll St
Salisbury, MD 21801
Phone (410) 546-6400

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1376092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1003249319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 ENGLE ST",
            "address_2": "ENGLEWOOD HOSPITAL-DEPARTAMENT OF MEDICINE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311808",
            "telephone_number": "201-984-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ENGLE ST",
            "address_2": "ENGLEWOOD HOSPITAL-DEPARTAMENT OF MEDICINE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311808",
            "telephone_number": "201-984-3664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVAR-AGUIRRE",
        "first_name": "JORGE",
        "middle_name": "LUIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-10",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D80895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.