Bergen Endocrinology, PC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

25MA08384100 Issued in NJ

Legal business name

BERGEN ENDOCRINOLOGY, PC

Practice address

12-04 Saddle River Rd
Fair Lawn, NJ 07410-5811

Phone

(201) 773-8710

Fax

(201) 773-8711

NPI assigned

Sep 29, 2008

Organization subpart

No

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

Authorized official

Name

Dima YeshouNPI 1124287412

Title

MD

Phone

(201) 281-7835

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dima Yeshou, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Fair Lawn, NJ
  • NPI 1124287412
  Medicare reassignment NPD Authorized official
• Maurice Rachko, MD

  • Cardiovascular Disease Physician
  • New York, NY
  • NPI 1730163825
  NPD (past)

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444694400000",
    "number": "1023268976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 CLINTON RD",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "07652",
            "telephone_number": "201-967-8425",
            "fax_number": "201-263-4665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12-04 SADDLE RIVER RD",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074105811",
            "telephone_number": "201-773-8710",
            "fax_number": "201-773-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN ENDOCRINOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-29",
        "last_updated": "2015-10-13",
        "status": "A",
        "authorized_official_last_name": "YESHOU",
        "authorized_official_first_name": "DIMA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "201-281-7835"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA08384100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0190861",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Rose Benson, M.A. CCC-SLP, CBIS
• David Berenbaum, RPT
• Bergen Arts and Science Charter Schools
• Bergen Chiropractic and Performance
• Bergen County Anesthesia LLC
• Bergen Enterprises Center LLC (North Jersey Recovery Center)
• Bergen Passaic Periodontal Group, PA
• Bergen Physical Therapy
• Bergen-Passaic Cataract Laser and Surgery Center, LLC (Bergen-Passaic Eye Surgery Center)
• Deborah Dorothea Berger, LPC

• Endocrinology, Diabetes & Metabolism Physician in Fair Lawn, NJ
• Providers in Fair Lawn, NJ by specialty
• Endocrinology, Diabetes & Metabolism Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.