Individual provider Active NPI

Elliot Wiesenfeld

  • Cardiovascular Disease Physician
  • Englewood, NJ
National Provider Identifier
1194118794
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA11791000 Issued in NJ
Practice address
25 Rockwood PL Ste 440
Englewood, NJ 07631-4987
Phone
(201) 568-3690
NPI assigned
Mar 6, 2015
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MA11791000 NJ Primary

Addresses

Primary practice location

25 Rockwood PL Ste 440
Englewood, NJ 07631-4987

Mailing address

25 Rockwood PL Ste 440
Englewood, NJ 07631-4987
Phone (201) 568-3690

Other practice location 1

Northwestern Medicine McGaw Medical Center
240 E Huron Street, Suite 1-200
Chicago, IL 60611-2909
Phone (312) 503-7975

Other identifiers 1

IdentifierTypeStateIssuer
0917061MedicaidNJ

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
I20230731000035 NJ Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0547621153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Northwestern University Feinberg Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

25 Rockwood PL
Suite 440
Englewood, NJ 07631-4987
Phone (201) 568-3690

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11791000NJMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC Internal Medicine CurrentSince Jul 24, 2023 Accepting new patients
Cardiovascular Associates of North Jersey, P.C. Cardiovascular Disease PastSince Jul 24, 2023 Accepting new patients

Locations

25 Rockwood Pl
Ste 440
Englewood, NJ 07631
Phone (201) 568-3690

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

Organizations & group practices 2

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": "1425600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1194118794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 ROCKWOOD PL STE 440",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314987",
            "telephone_number": "201-568-3690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ROCKWOOD PL STE 440",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314987",
            "telephone_number": "201-568-3690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Northwestern Medicine McGaw Medical Center",
            "address_2": "240 E Huron Street, Suite 1-200",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112909",
            "country_code": "US",
            "telephone_number": "312-503-7975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIESENFELD",
        "first_name": "ELLIOT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-06",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA11791000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0917061",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.