NPIMap

Individual provider Active NPI

Jared Mark Wasserman, M.D.

  • Otolaryngology Physician
  • Hackensack, NJ
National Provider Identifier
1194923847
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
25MA08244600 Issued in NJ
Practice address
433 Hackensack Ave Ste 204
Hackensack, NJ 07601-6319
Phone
(201) 883-1062
NPI assigned
Jul 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 233407 MA
Otolaryngology Physician 207Y00000X 25MA08244600 NJ Primary

Addresses

Primary practice location

433 Hackensack Ave Ste 204
Hackensack, NJ 07601-6319

Mailing address

660 White Plains Rd FL 4
Tarrytown, NY 10591-5139
Phone (914) 984-2546

Other identifiers 2

IdentifierTypeStateIssuer
P00675979OtherNJRAILROAD MEDICARE
D09303400OtherNJCDS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081209000398 NJ Practitioner - Otolaryngology 5294896247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Icahn School of Medicine at Mount Sinai, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates LLPGroup PAC ID 0749193662, 431 clinicians

Practice addresses (Care Compare)

1211 Hamburg Tpke
Suite 205
Wayne, NJ 07470-5056
Phone (973) 633-0808

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.45 of 100Reported as group
Quality
89.91
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
233407MAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates LLP Otolaryngology CurrentSince Sep 1, 2008 Accepting new patients
ENT and Allergy Associates of Pennsylvania PLLC Otolaryngology Past Accepting new patients

Locations

433 Hackensack Ave
Ste 204
Hackensack, NJ 07601
Phone (201) 883-1062

433 Hackensack Ave
Fl 2
Hackensack, NJ 07601
Phone (201) 343-1717

1211 Hamburg Tpke
Ste 205
Wayne, NJ 07470
Phone (973) 633-0808

660 White Plains Rd
Fl 4
Tarrytown, NY 10591
Phone (914) 984-2546

1086 N Broadway
Ste 220
Yonkers, NY 10701
Phone (914) 279-9500

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jared.wasserman@direct.entandallergy.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1183507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1194923847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 WHITE PLAINS RD FL 4",
            "city": "TARRYTOWN",
            "state": "NY",
            "postal_code": "105915139",
            "telephone_number": "914-984-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 HACKENSACK AVE STE 204",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016319",
            "telephone_number": "201-883-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "JARED",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-04",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "233407",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": "25MA08244600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00675979",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS",
            "identifier": "D09303400",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.