Christine Vivolo, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00818000 Issued in NJ

Practice address

230 E Ridgewood Ave
Paramus, NJ 07652-4142

Phone

(201) 597-4130

NPI assigned

Dec 26, 2023

Last updated

Dec 26, 2023By the provider in NPPES

Sex

Female

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: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

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

Physician Assistant

State licenses

Practice roles

Locations

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
• Bergen County Improvement Authority

  dba Bergen New Bridge Medical Center

  • Psychiatric Hospital Unit
  • Paramus, NJ
  • NPI 1952456295
  NPD

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": "1703548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1043089576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E RIDGEWOOD AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076524142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E RIDGEWOOD AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076524142",
            "telephone_number": "201-597-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVOLO",
        "first_name": "CHRISTINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-26",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00818000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kajal Viradia
• Visage Surgical LLC
• Jack H Vitenson, M.D.
• Anne Vitiello, LCSW
• Natalia Vives, OTR/L
• Samantha Grace Voltmer, LSW
• VSML LLC (New Path Psychotherapy)
• Krina A Vyas, M.D.
• Rushikesh Harishkumar Vyas, MD
• Amanda Wagner, PSY.D., LPC

• Surgical Physician Assistant in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.