Active NPI
Hackensack Vascular Specialists LLC
- Specialist
- Hackensack, NJ
National Provider Identifier
1063840239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 25MB08446100
- 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
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Dr. Gregory Simonian, MD
- Title
- President
- Phone
- (201) 487-8882
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131220000045 | NJ | Part B Supplier - Clinic/Group Practice | 5597992412 |
Receives reassigned benefits from 4 practitioners Practice locations: Hackensack, NJ |
National Provider Directory
National Provider DirectorySpecialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 25MB08446100 | NJ | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
211 Essex St Ste 102
Hackensack, NJ 07601-3244
Mailing address
211 Essex St Ste 102
Hackensack, NJ 07601-3244
Phone (201) 487-8882
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 17, 2013.
{
"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": []
}
Other providers in Hackensack, NJ
- Hackensack University Medical Center
- Hackensack University Medical Center
- Hackensack University Medical Center Harp
- Hackensack University Medical Group, PC
- Hackensack Vascular Center, P.C.
- Hackensack Volunteer Ambulance Corps, Inc.
- Hackenscack University Medical Center Dialysis
- Andrew Haddad, M.D.
- Moussa Haddad, D.D.S
- Gonxhe Hadzi, AGPCNP
Sources for this page
- 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.