Angelo C Mabasa, DNP, NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

26NJ00133000 Issued in NJ

Practice address

718 Teaneck Rd
Teaneck, NJ 07666-4245

Phone

(201) 530-7917

Fax

(212) 305-8304

NPI assigned

Sep 19, 2007

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bergen County Improvement AuthorityGroup PAC ID 9032104047, 95 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bergen New Bridge Medical Center Hospital, Paramus, NJ, CCN 310058

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
• FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

• Bergen County Improvement Authority

  dba Bergen New Bridge Medical Center Medical Provider Group

  • Internal Medicine Physician
  • Paramus, NJ
  • NPI 1891836441
  Medicare reassignment Care Compare group NPD
• The Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1265598783

  Adult Health

  Medicare reassignment NPD
• Trustees of Columbia University in the City of New York

  • Surgery Physician
  • New York, NY
  • NPI 1508266347
  Medicare reassignment NPD
• Bergen County Improvement Authority

  dba Bergen New Bridge Medical Center

  • Psychiatric Hospital Unit
  • Paramus, NJ
  • NPI 1952456295
  NPD
• Trustees of Columbia University in the City of New York

  • Anesthesiology Physician
  • New York, NY
  • NPI 1477068971
  NPD
• Trustees of Columbia University in the City of New York

  • Internal Medicine Physician
  • New York, NY
  • NPI 1699289488
  NPD
• Columbia Doctors of New Jersey, P. C.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Ridgewood, NJ
  • NPI 1144459991
  NPD (past)

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

• Bergen County Improvement Authority

  dba Bergen New Bridge Medical Center

  • General Acute Care Hospital
  • Paramus, NJ
  • NPI 1689682999
  Care Compare affiliation

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1033305578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 SUMMIT AVE",
            "city": "NEW MILFORD",
            "state": "NJ",
            "postal_code": "076461718",
            "telephone_number": "201-281-8840",
            "fax_number": "201-634-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 TEANECK RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664245",
            "telephone_number": "201-530-7917",
            "fax_number": "212-305-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABASA",
        "first_name": "ANGELO",
        "middle_name": "C",
        "credential": "DNP, NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-19",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "305372-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00133000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "SOAP",
            "affiliation": "N",
            "endpointDescription": "SOAP",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Document",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Document",
            "address_1": "622 W 168th St Ste 1271",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100323720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joel Lupatkin, MD
• Michelle Ilene Lupkin, PH.D.
• Katelyn Marie Luter, NP
• Lisa Lyons, PH. D.
• M Leibman OBGYN LLC
• Keeva Christine Madden, MD
• Rosa Madrid-Echo, D.M.D
• Leyat Mafouda, MA, CCC-SLP
• Angela J. Magno, RN
• Maria Mahabir

• Adult Health Nurse Practitioner in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Adult Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.