Hackensack Vascular Specialists LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MB08446100 Issued in NJ

Legal business name

HACKENSACK VASCULAR SPECIALISTS LLC

Practice address

211 Essex St Ste 102
Hackensack, NJ 07601-3244

Phone

(201) 487-8882

Fax

(201) 487-0943

NPI assigned

Oct 24, 2013

Last updated

Dec 17, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gregory Simonian, MDNPI 1528017944

Title

President

Phone

(201) 487-8882

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kristin Cook, MD

  • Vascular Surgery Physician
  • Hackensack, NJ
  • NPI 1093976466
  Medicare reassignment Care Compare group NPD
• James William Geuder, MD

  • Vascular Surgery Physician
  • Hackensack, NJ
  • NPI 1619022068
  Medicare reassignment Care Compare group NPD
• Anjali Ratnathicam, DO

  • Surgery Physician
  • Hackensack, NJ
  • NPI 1922257252
  Medicare reassignment Care Compare group NPD
• Gregory T Simonian, MD

  • Vascular Surgery Physician
  • Hackensack, NJ
  • NPI 1528017944
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387238400000",
    "number": "1063840239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 ESSEX ST STE 102",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076013244",
            "telephone_number": "201-487-8882",
            "fax_number": "201-487-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 ESSEX ST STE 102",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076013244",
            "telephone_number": "201-487-8882",
            "fax_number": "201-487-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKENSACK VASCULAR SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-24",
        "last_updated": "2013-12-17",
        "status": "A",
        "authorized_official_last_name": "SIMONIAN",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-487-8882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MB08446100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hackensack University Medical Center (Ellen H. Lazar Shoppe on Fifth)
• Hackensack University Medical Center (John Theurer Cancer Center Pharmacy)
• Hackensack University Medical Center Harp
• Hackensack University Medical Group, PC
• Hackensack Vascular Center, P.C.
• Hackensack Volunteer Ambulance Corps, Inc. (Hackensack Volunteer Ambulance Corps)
• Hackenscack University Medical Center Dialysis
• Andrew Haddad, M.D.
• Moussa Haddad, D.D.S
• Gonxhe Hadzi, AGPCNP

• Specialist in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.