Individual provider Active NPI

Stephen Percy Jr., MD

  • Pediatric Critical Care Medicine Physician
  • Hackensack, NJ
National Provider Identifier
1063586485
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
25MA05674700 Issued in NJ
Practice address
30 Prospect Ave
Hackensack University Medical Center
Hackensack, NJ 07601-1914
Phone
(201) 996-5201
Fax
(201) 996-0754
NPI assigned
Nov 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 25MA05674700 NJ Primary

Addresses

Primary practice location

30 Prospect Ave
Hackensack University Medical Center
Hackensack, NJ 07601-1914

Mailing address

30 Prospect Ave
Hackensack University Medical Center
Hackensack, NJ 07601-1914
Phone (201) 996-5201

Other identifiers 1

IdentifierTypeStateIssuer
7718403MedicaidNJ

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110721000515 NJ Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 9133397904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Critical Care (Intensivists)
Education
Rutgers New Jersey Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-5045

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jul 1, 2011 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Jul 1, 2011 Accepting new patients
HMH Hospitals Corporation Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: stephen.percy@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063586485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "address_2": "HACKENSACK UNIVERSITY MEDICAL CENTER",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011914",
            "telephone_number": "201-996-5201",
            "fax_number": "201-996-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "address_2": "HACKENSACK UNIVERSITY MEDICAL CENTER",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011914",
            "telephone_number": "201-996-5201",
            "fax_number": "201-996-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERCY",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NJ",
            "license": "25MA05674700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7718403",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.