Nicholas G Baranetsky, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

MA046790 Issued in NJ

Practice address

268 Dr Martin Luther King Jr Blvd Ste B
Newark, NJ 07102-2011

Phone

(973) 877-5185

NPI assigned

Oct 2, 2006

Last updated

Mar 30, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

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

Specialty

EndocrinologyAlso: Internal Medicine

Education

New York Medical College, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Avenue Professional Services, PCGroup PAC ID 7214258003, 49 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Michael's Medical Center Hospital, Newark, NJ, CCN 310096

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ngbmd@direct.practicefusion.com

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.

• Central Avenue Professional Services, PC

  • Critical Care Medicine (Internal Medicine) Physician
  • Newark, NJ
  • NPI 1447649694
  Medicare reassignment Care Compare group NPD
• Prime Healthcare Services - St Michaels LLC

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1568825545
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prime Healthcare Services - St Michaels LLC

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1568825545
  Care Compare affiliation

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1093808164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 298",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "07039",
            "telephone_number": "973-877-5185",
            "fax_number": "973-877-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 DR MARTIN LUTHER KING JR BLVD STE B",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022011",
            "telephone_number": "973-877-5185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 CENTRAL AVE",
            "address_purpose": "LOCATION",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07102",
            "country_code": "US",
            "telephone_number": "973-877-5185",
            "fax_number": "973-877-5210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARANETSKY",
        "first_name": "NICHOLAS",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "MA046790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "28530",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1080709",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "E5102",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ngbmd@direct.practicefusion.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "268 Dr Martin Luther King Jr Blvd Ste B",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071022011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sukriti Bansal
• Shruti Banugaria, M.D.
• Maria Martha Baptiste, APRN-BC
• Nirajan Baral
• Natalia Baran, M.D.
• Katherine Baranowski, M.D.
• Vincent J. Barba, M.D.
• Gabriel Barbosa, DPT
• Marva Monique, Natasha Barbour, APN
• Michele Alexis Bardzinski, D.M.D.

• Endocrinology, Diabetes & Metabolism Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Endocrinology, Diabetes & Metabolism Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.