NPIMap

Individual provider Active NPI

Dusan Knezevic, MD

  • Cardiovascular Disease Physician
  • Glen Ridge, NJ
National Provider Identifier
1023062866
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA07449000 Issued in NJ
Practice address
123 Highland Ave
Suite 302
Glen Ridge, NJ 07028-1527
Phone
(973) 748-9555
Fax
(973) 748-2003
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MA07449000 NJ Primary

Addresses

Primary practice location

123 Highland Ave
Suite 302
Glen Ridge, NJ 07028-1527

Mailing address

123 Highland Ave
Suite 302
Glen Ridge, NJ 07028-1527
Phone (973) 748-9555

Other identifiers 1

IdentifierTypeStateIssuer
9127402MedicaidNJ

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
I20040426000178 NJ Practitioner - Cardiovascular Disease (Cardiology) 0042206856 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

311 Bay Ave
Suite 100
Glen Ridge, NJ 07028-1621
Phone (973) 748-9555

Hospital & facility affiliations

  • Hackensack Meridian Mountainside Medical Hospital, Montclair, NJ, CCN 310054
  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
  • St Joseph'S University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07449000NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Nov 10, 2018 Accepting new patients
MPV New Jersey MD Services PC CurrentSince Jan 1, 2022 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Nov 10, 2018 Accepting new patients
Humc Cardiovascular Partners, PC Cardiovascular Disease CurrentSince Dec 25, 2013 Accepting new patients
MPV New Jersey MD Services PC CurrentSince Jan 1, 2022 Accepting new patients
LH Emergency Medical Services PC Past Accepting new patients
Trustees Columbia University City Ny Center Interventional Vascular TH Past Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients
Dr Anthony M Pastena LLC Past Accepting new patients

Locations

1 Metro Blvd
Ste 2B
Clifton, NJ 07014
Phone (973) 230-6616

123 Highland Ave
Ste 302
Glen Ridge, NJ 07028
Phone (973) 748-9555

123 Highland Ave
Glen Ridge, NJ 07028
Phone (973) 746-7474

311 Bay Ave
Ste 100
Glen Ridge, NJ 07028
Phone (551) 996-9250

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

1 Bay Ave
Montclair, NJ 07042
Phone (973) 429-6100

Interoperability endpoints

  • Direct secure messaging: dusan.knezevic@direct.hackensackmeridian.org
  • Direct secure messaging: dknezevic188843@ahs.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 4

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1023062866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 HIGHLAND AVE",
            "address_2": "SUITE 302",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281527",
            "telephone_number": "973-748-9555",
            "fax_number": "973-748-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 HIGHLAND AVE",
            "address_2": "SUITE 302",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281527",
            "telephone_number": "973-748-9555",
            "fax_number": "973-748-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNEZEVIC",
        "first_name": "DUSAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA07449000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9127402",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ridge, NJ

Sources for this page

Verify at the official NPI Registry.