Edward Petrarca, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC00016500 Issued in NJ

Practice address

1 Bay Ave
Mountainside Hospital
Montclair, NJ 07042-4837

Phone

(973) 429-6813

Fax

(973) 680-7715

NPI assigned

Nov 9, 2006

Last updated

Jul 10, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Montclair Hospital LLCGroup PAC ID 7810092814, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hackensack Meridian Mountainside Medical Hospital, Montclair, NJ, CCN 310054

Merit-based Incentive Payment System (MIPS)

Final score

94.4 of 100Reported as group

Quality

94.62

Promoting interoperability

100

Improvement activities

40

Cost

70.04

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Montclair Hospital LLC

  dba Outpatient Behavioral Health Department

  • Adult Mental Health Clinic/Center
  • Montclair, NJ
  • NPI 1386893659
  Medicare reassignment Care Compare group

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

• Montclair Hospital LLC

  dba HackensackUMC Mountainside

  • General Acute Care Hospital
  • Montclair, NJ
  • NPI 1982720249
  Care Compare affiliation

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1003986787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAY AVE",
            "address_2": "MOUNTAINSIDE HOSPITAL",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424837",
            "telephone_number": "973-429-6000",
            "fax_number": "973-680-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAY AVE",
            "address_2": "MOUNTAINSIDE HOSPITAL",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424837",
            "telephone_number": "973-429-6813",
            "fax_number": "973-680-7715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRARCA",
        "first_name": "EDWARD",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00016500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Perez, MSW, BCBA
• Lauren Perez, LAC
• Rachel H Perlman, LCSW
• Aniella Lincoln Perold, PHD
• Brianna Peterson
• Kristen Ernst Petterson, RD
• Andrea Peyser, LCSW
• Bruce Phariss, MD
• Physical Medicine and Rehabilitation Associates LLC
• Kevin Picardo, DPT

• Clinical Social Worker in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.