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Individual provider Active NPI

Brook A Dejene, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Neptune, NJ
National Provider Identifier
1013918416
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
57722 Issued in NJ
Practice address
1944 Route 33
Mid-Atlantic Surgical Associates - Suite 201
Neptune, NJ 07753-4862
Phone
(732) 776-4622
Fax
(732) 776-3765
NPI assigned
Aug 9, 2005
Last updated
Nov 16, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 57722 NJ Primary

Addresses

Primary practice location

1944 Route 33
Mid-Atlantic Surgical Associates - Suite 201
Neptune, NJ 07753-4862

Mailing address

100 Madison Ave
Mid-Atlantic Surgical Associates
Morristown, NJ 07960-6136
Phone (973) 971-7300

Other identifiers 1

IdentifierTypeStateIssuer
6410600MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051018000841 NJ Practitioner - Cardiac SurgeryPractitioner - Thoracic Surgery 7012933104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Surgery
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Atlantic Surgical Assoc.Group PAC ID 1658356670, 5 clinicians

Practice addresses (Care Compare)

1944 Route 33
Suite 201
Neptune, NJ 07753-4863
Phone (732) 776-4622

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
57.32 of 100Reported as individual
Quality
0
Improvement activities
40
Cost
77.27

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57722NJMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Surgical Associates Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Nov 9, 1993 Accepting new patients
Mid-Atlantic Surgical Assoc. Thoracic Surgery (Cardiothoracic Vascular Surgery) Current Accepting new patients
Jersey Shore Cardiothoracic and Vascular Surgery Associates PA Thoracic Surgery (Cardiothoracic Vascular Surgery) PastSince May 8, 1995 Accepting new patients

Locations

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

1944 State Route 33
Ste 201
Neptune, NJ 07753
Phone (732) 776-4618

Organizations & group practices 3

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1013918416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE",
            "address_2": "MID-ATLANTIC SURGICAL ASSOCIATES",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606136",
            "telephone_number": "973-971-7300",
            "fax_number": "973-984-7019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1944 ROUTE 33",
            "address_2": "MID-ATLANTIC SURGICAL ASSOCIATES - SUITE 201",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534862",
            "telephone_number": "732-776-4622",
            "fax_number": "732-776-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJENE",
        "first_name": "BROOK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NJ",
            "license": "57722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6410600",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

Verify at the official NPI Registry.