Individual provider Active NPI

Patrick Hines, MD

  • Diagnostic Radiology Physician
  • Nutley, NJ
National Provider Identifier
1073614939
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25MA05292900 Issued in NJ
Practice address
20 High St
Nutley, NJ 07110-1132
Phone
(973) 284-0020
Fax
(973) 284-6310
NPI assigned
Sep 25, 2006
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25MA05292900 NJ Primary

Addresses

Primary practice location

20 High St
Nutley, NJ 07110-1132

Mailing address

777 Passaic Ave
Suite 360
Clifton, NJ 07012-1804
Phone (973) 284-0020

Other practice location 1

97 W Parkway
Pompton Plains, NJ 07444-1647
Phone (973) 831-5089

Other identifiers 1

IdentifierTypeStateIssuer
5396107MedicaidNJ

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
I20050812000291 NJ Practitioner - Diagnostic Radiology 7012946700 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ancillary Services of Practice Associates PAGroup PAC ID 4981026192, 99 clinicians

Practice addresses (Care Compare)

97 W Pkwy
Chilton Medical Center
Pompton Plains, NJ 07444-1647
Phone (973) 831-5089

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05292900NJMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ancillary Services of Practice Associates PA Diagnostic Radiology CurrentSince Nov 21, 2023 Accepting new patients
Hunterdon Ambulatory Services LLC CurrentSince Nov 21, 2023 Accepting new patients
Montclair Radiological Assoc ,PA Diagnostic Radiology CurrentSince Aug 1, 2008 Accepting new patients
Women's Healthcare Imaging, Corp. CurrentSince Jan 9, 2025 Accepting new patients
Atlantic Imaging Services LLC Diagnostic Radiology CurrentSince Nov 21, 2023 Accepting new patients
Diagnostic Imaging Associates of North Jersey PA PastSince Jan 1, 2007 Accepting new patients

Locations

471 Broadway
Ste 400
Bayonne, NJ 07002
Phone (973) 436-0511

1121 Route 22
Ste 103
Bridgewater, NJ 08807
Phone (908) 237-4001

100 Commerce Pl
Clark, NJ 07066
Phone (732) 388-2620

140 Central Ave
Ste 600
Clark, NJ 07066
Phone (732) 943-5030

4 Brighton Rd
Ste 200
Clifton, NJ 07012
Phone (718) 876-2000

777 Passaic Ave
Ste 360
Clifton, NJ 07012

116 Park St
Montclair, NJ 07042
Phone (973) 661-4674

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

20 High St
Nutley, NJ 07110
Phone (973) 281-1881

3025 Paramus Park Mall
Ste 300
Paramus, NJ 07652
Phone (201) 267-6889

10 Lanidex Plz W
Ste 125
Parsippany, NJ 07054
Phone (973) 267-1274

97 W Parkway
Pompton Plns, NJ 07444
Phone (973) 831-5000

1000 Galloping Hill Rd
Union, NJ 07083
Phone (908) 522-6280

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 5

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1073614939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 PASSAIC AVE",
            "address_2": "SUITE 360",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121804",
            "telephone_number": "973-284-0020",
            "fax_number": "973-284-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HIGH ST",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101132",
            "telephone_number": "973-284-0020",
            "fax_number": "973-284-6310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "97 W Parkway",
            "address_purpose": "LOCATION",
            "city": "Pompton Plains",
            "state": "NJ",
            "postal_code": "074441647",
            "country_code": "US",
            "telephone_number": "973-831-5089",
            "fax_number": "973-831-5512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HINES",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA05292900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5396107",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nutley, NJ

Sources for this page

Verify at the official NPI Registry.