NPIMap

Individual provider Active NPI

Vikas S. Bawa, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Newark, NJ
National Provider Identifier
1053480475
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
25MD00260200 Issued in NJ
Practice address
1060 Broad St
Lower Level Medical Office
Newark, NJ 07102-2397
Phone
(973) 642-6500
Fax
(973) 741-2700
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 25MD00260200 NJ Primary

Addresses

Primary practice location

1060 Broad St
Lower Level Medical Office
Newark, NJ 07102-2397

Mailing address

12 Sherwood LN
Columbus, NJ 08022-2248
Phone (973) 906-3344

Other identifiers 1

IdentifierTypeStateIssuer
8560005MedicaidNJ

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
I20110308000702 NJ Practitioner - Podiatry 8921194879 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1060 Broad St
Suite C
Newark, NJ 07102-2397
Phone (973) 906-3344

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue592
Removal of nail tissue395
Removal or shaving of skin growth27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fellowship Village Inc. CurrentSince Aug 28, 2020 Accepting new patients
Fellowship Senior Living, Inc. CurrentSince Aug 28, 2020 Accepting new patients
Advanced Foot & Ankle Center Inc. Foot & Ankle Surgery CurrentSince Jul 26, 2010 Accepting new patients
Neighborhood Health Services Corporation CurrentSince May 13, 2017 Accepting new patients
East Village Foot Care, PC PastSince Jan 1, 2003 Accepting new patients

Locations

8000 Fellowship Rd
Basking Ridge, NJ 07920
Phone (908) 580-3800

516 Bergen St
Newark, NJ 07108
Phone (201) 633-5773

1700 Myrtle Ave
#58
Plainfield, NJ 07063
Phone (908) 753-6401

Interoperability endpoints

  • Direct secure messaging: vikas.bawa.p1@direct.nhscnj.nextgenshare.com
  • Direct secure messaging: vbawa255750@epicdirect.rwjbh.org
  • FHIR API: https://api.platform.athenahealth.com/19916/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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 2

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220486400000",
    "number": "1053480475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SHERWOOD LN",
            "city": "COLUMBUS",
            "state": "NJ",
            "postal_code": "080222248",
            "telephone_number": "973-906-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 BROAD ST",
            "address_2": "LOWER LEVEL MEDICAL OFFICE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022397",
            "telephone_number": "973-642-6500",
            "fax_number": "973-741-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAWA",
        "first_name": "VIKAS",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2008-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00260200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8560005",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.