Individual provider Active NPI

Andranik Howhannesian

  • Urology Physician
  • Fair Lawn, NJ
National Provider Identifier
1174591762
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
25MA06432200 Issued in NJ
Practice address
14-01 Broadway Ste 3
Fair Lawn, NJ 07410-2008
Phone
(201) 791-4544
NPI assigned
Mar 9, 2006
Last updated
May 10, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 25MA06432200 NJ Primary

Addresses

Primary practice location

14-01 Broadway Ste 3
Fair Lawn, NJ 07410-2008

Mailing address

85 Harristown Rd FL 2
Glen Rock, NJ 07452-3329
Phone (201) 855-8446

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
I20100920000140 NJ Practitioner - Urology 8820124621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Boston University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sovereign Medical Group LLCGroup PAC ID 1456535392, 20 clinicians

Practice addresses (Care Compare)

14 -01 Broadway
Suite B
Fair Lawn, NJ 07410-2008
Phone (201) 855-8455

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.05 of 100Reported as apm
Quality
85.71
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sovereign Medical Group LLC Urology CurrentSince Mar 1, 2011 Accepting new patients
Sovereign Medical Group, LLC CurrentSince Mar 1, 2011 Accepting new patients
Surgicare Surgical Associates of Fairlawn, LLC Past Accepting new patients
Urology Specialty Care PA Past Accepting new patients
Hackensack Radiation Therapy LLC PastSince Jan 1, 2011 Accepting new patients

Locations

1401 Broadway
Ste 3
Fair Lawn, NJ 07410
Phone (201) 279-6340

15-01 Broadway
Ste 1
Fair Lawn, NJ 07410
Phone (201) 703-8487

85 Harristown Rd
Fl 2
Glen Rock, NJ 07452
Phone (201) 703-5500

85 Harristown Rd
Ste 1200
Glen Rock, NJ 07452

85 Harristown Rd
Ste 200
Glen Rock, NJ 07452
Phone (201) 444-4526

680 Kinderkamack Rd
Ste 300
Oradell, NJ 07649
Phone (201) 881-7869

Interoperability endpoints

  • Direct secure messaging: ahowhannesian189789@ahs.direct-ci.com
  • Direct secure messaging: andranik.howhannesian.1@5622.direct.athenahealth.com

Organizations & group practices 5

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 1

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1174591762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HARRISTOWN RD FL 2",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074523329",
            "telephone_number": "201-855-8446",
            "fax_number": "201-444-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14-01 BROADWAY STE 3",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102008",
            "telephone_number": "201-791-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWHANNESIAN",
        "first_name": "ANDRANIK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2018-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MA06432200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

Verify at the official NPI Registry.