NPIMap

Organization Active NPI

Vantage Health System, Inc.

  • Community/Behavioral Health Agency
  • Englewood, NJ
National Provider Identifier
1144354861
Registry record updated May 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
923550204 Issued in NJ
Legal business name
VANTAGE HEALTH SYSTEM, INC.
Practice address
93 W Palisade Ave
Englewood, NJ 07631-2611
Phone
(201) 567-5500
Fax
(201) 567-9335
NPI assigned
Mar 15, 2007
Last updated
May 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2013

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

Authorized official

Name
Victoria L. Sidrow
Title
President & Ceo
Phone
(201) 385-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 923550204 NJ Primary

Addresses

Primary practice location

93 W Palisade Ave
Englewood, NJ 07631-2611

Mailing address

93 W Palisade Ave
Englewood, NJ 07631-2611
Phone (201) 567-5500

Other identifiers 1

IdentifierTypeStateIssuer
0005916MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420000212 NJ Part B Supplier - Clinic/Group Practice 8325033178 Receives reassigned benefits from 14 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dumont, NJ; Englewood, NJ

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Vantage Health System Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369872000000",
    "number": "1144354861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 W PALISADE AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312611",
            "telephone_number": "201-567-5500",
            "fax_number": "201-567-9335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 W PALISADE AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312611",
            "telephone_number": "201-567-5500",
            "fax_number": "201-567-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANTAGE HEALTH SYSTEM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2013-05-30",
        "status": "A",
        "authorized_official_last_name": "SIDROW",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "201-385-4400"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "923550204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005916",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

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

Verify at the official NPI Registry.