Jeffrey Whitworth, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

MA063604 Issued in NJ

Practice address

1031 McBride Ave
Suite D203
West Paterson, NJ 07424-2559

Phone

(973) 256-6350

Fax

(973) 256-7388

NPI assigned

Jun 5, 2006

Last updated

Jul 30, 2010By 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 10

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

Dermatology

Education

University of Oklahoma College of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlantic Dermatology Associates, LLCGroup PAC ID 6204090277, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwhitworth@directaddress.net

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.

• Atlantic Dermatology Associates, LLC

  • Dermatology Physician
  • West Paterson, NJ
  • NPI 1699988485
  Medicare reassignment Care Compare group NPD Authorized official
• Ahkami Dermatology Associates, LLC

  • Dermatology Physician
  • Woodland Park, NJ
  • NPI 1396172292
  NPD (past)
• The Dermatology Clinic PA

  dba The Dermatology Clinic PA-Malvern Ave Clinic

  • Dermatology Physician
  • Hot Springs, AR
  • NPI 1720611635
  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280448000000",
    "number": "1144269440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 MCBRIDE AVE",
            "address_2": "SUITE D203",
            "city": "WEST PATERSON",
            "state": "NJ",
            "postal_code": "074242559",
            "telephone_number": "973-256-6350",
            "fax_number": "973-256-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 MCBRIDE AVE",
            "address_2": "SUITE D203",
            "city": "WEST PATERSON",
            "state": "NJ",
            "postal_code": "074242559",
            "telephone_number": "973-256-6350",
            "fax_number": "973-256-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITWORTH",
        "first_name": "JEFFREY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2010-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NJ",
            "license": "MA063604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2299410",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHP",
            "identifier": "60000896",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2145328",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY HEALTH PLAN",
            "identifier": "31686",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2K3839",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0376198000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2881489",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8050708",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "91000267201",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BCBS",
            "identifier": "223812197",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Vitale, MD
• Volunteers of America-Gny
• Shawnalyn Weigel, M. P. T.
• West Paterson Family Chiropractic Center
• West Paterson Family Medical Center,PA
• Womens OB GYN PC
• Sarla J Zaveri, M.D.
• Yousef Zibdie, MD
• Janine J. Zolty, PA

• MOHS-Micrographic Surgery Physician in West Paterson, NJ
• Providers in West Paterson, NJ by specialty
• MOHS-Micrographic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2010; 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.