NPIMap

Organization Active NPI

Bergen Anesthesia Group, P.C.

  • Specialist
  • Ridgewood, NJ
National Provider Identifier
1194816249
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
BERGEN ANESTHESIA GROUP, P.C.
Practice address
223 N Van Dien Ave
Operating Room
Ridgewood, NJ 07450-2726
Phone
(201) 847-9403
NPI assigned
Sep 27, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael Scognamiglio, MDNPI 1316901671
Title
President
Phone
(201) 847-9320

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

223 N Van Dien Ave
Operating Room
Ridgewood, NJ 07450-2726

Mailing address

500 W Main St
Suite 16
Wyckoff, NJ 07481-1439
Phone (201) 847-9320

Other identifiers 1

IdentifierTypeStateIssuer
7035101MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040419000098 NJ Part B Supplier - Clinic/Group Practice 6608861794 Receives reassigned benefits from 77 practitioners
Practice locations: Paramus, NJ; Ridgewood, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 86

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 86

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194816249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W MAIN ST",
            "address_2": "SUITE 16",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811439",
            "telephone_number": "201-847-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N VAN DIEN AVE",
            "address_2": "OPERATING ROOM",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502726",
            "telephone_number": "201-847-9403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN ANESTHESIA GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCOGNAMIGLIO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-847-9320",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7035101",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.