Individual provider Active NPI

Richard Seides, NP-C

  • Adult Health Nurse Practitioner
  • Clifton, NJ
National Provider Identifier
1174717011
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NN10535200 Issued in NJ
Practice address
709 Allwood Rd
Clifton, NJ 07012-2004
Phone
(973) 652-3922
NPI assigned
Sep 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NN10535200 NJ Primary

Addresses

Primary practice location

709 Allwood Rd
Clifton, NJ 07012-2004

Mailing address

709 Allwood Rd
Clifton, NJ 07012-2004
Phone (973) 652-3922

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130510000046 NJ Practitioner - Nurse Practitioner 8022255066 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care of New Jersey PC CurrentSince Jan 4, 2020 Accepting new patients
Medical Service Professionals of NJ LLC CurrentSince Aug 9, 2024 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Jan 4, 2020 Accepting new patients
A.G. Dikengil, MD, PA Past Accepting new patients
Riverside Medical Group Past Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

30 Montgomery St
Fl 15
Jersey City, NJ 07302
Phone (551) 247-1029

125 Chubb Ave
Ste 100S
Lyndhurst, NJ 07071
Phone (201) 559-7600

714 10th St
Secaucus, NJ 07094
Phone (201) 863-3346

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1174717011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 ALLWOOD RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070122004",
            "telephone_number": "973-652-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 ALLWOOD RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070122004",
            "telephone_number": "973-652-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIDES",
        "first_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NN10535200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.