Anthony R Cavazos, M.D.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

25MA07124300 Issued in NJ

Practice address

29 South St
New Providence, NJ 07974-2934

Phone

(908) 679-8181

Fax

(908) 679-8179

NPI assigned

Mar 27, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Family Practice

Education

University of Michigan Medical School, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: drc360.anthonycavazos@154922.advancedmd-direct.com

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.

• Drc360, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • New Providence, NJ
  • NPI 1679964795
  Medicare reassignment NPD Authorized official
• Madison Medical and Sports Rehabilitation L.L.C

  • Rehabilitation Clinic/Center
  • Madison, NJ
  • NPI 1952240822
  NPD (past)

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1104944263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 SOUTH ST",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079742934",
            "telephone_number": "908-679-8181",
            "fax_number": "908-679-8179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 SOUTH ST",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079742934",
            "telephone_number": "908-679-8181",
            "fax_number": "908-679-8179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Cedar Crest Dr",
            "address_purpose": "LOCATION",
            "city": "Pompton Plains",
            "state": "NJ",
            "postal_code": "074442100",
            "country_code": "US",
            "telephone_number": "973-831-3540",
            "fax_number": "973-831-3503",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "56 Newark St",
            "address_purpose": "LOCATION",
            "city": "Hoboken",
            "state": "NJ",
            "postal_code": "070304544",
            "country_code": "US",
            "telephone_number": "908-679-8181",
            "fax_number": "908-679-8179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAVAZOS",
        "first_name": "ANTHONY",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "NJ",
            "license": "25MA07124300",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA07124300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NJ",
            "identifier": "5221142040",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0203343",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "04-29599",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Caroline Gojcz Licsw LLC
• Carolyn Driscoll, Otr LLC
• CC Physical Therapy and Wellness, LLC
• Central Physical Therapy, LLC
• Lindsay Chaillet
• Yuchin Chang, DPT
• Kathleen Laura Chin, MD

• Geriatric Medicine (Family Medicine) Physician in New Providence, NJ
• Providers in New Providence, NJ by specialty
• Geriatric Medicine (Family Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.