NPIMap

Individual provider Active NPI

Rena Levykh-Chase, M.D.

  • Internal Medicine Physician
  • Fair Lawn, NJ
National Provider Identifier
1215085360
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA69109 Issued in NJ
Practice address
19-21 Fair Lawn Ave
Fair Lawn, NJ 07410-2331
Phone
(201) 791-8689
Fax
(201) 791-2589
NPI assigned
Jan 8, 2007
Last updated
Jan 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MA69109 NJ Primary

Addresses

Primary practice location

19-21 Fair Lawn Ave
Fair Lawn, NJ 07410-2331

Mailing address

19-21 Fair Lawn Ave
Fair Lawn, NJ 07410-2331
Phone (201) 791-8689

Other identifiers 1

IdentifierTypeStateIssuer
8296804MedicaidNJ

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
I20040310000135 NJ Practitioner - Internal Medicine 4183512197 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Icahn School of Medicine at Mount Sinai, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians

Practice addresses (Care Compare)

108 Jackson St
Apt 6B
Hoboken, NJ 07030-6101
Phone (800) 825-5391

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA69109NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physician Services PC Internal Medicine CurrentSince Sep 1, 2019 Accepting new patients
Sovereign Medical Group LLC Internal Medicine CurrentSince Jun 1, 2016 Accepting new patients
Sovereign Medical Group, LLC CurrentSince Jun 1, 2016 Accepting new patients
The Valley Hospital Inc. Past Accepting new patients
Physicians Health Alliance PA Internal Medicine Past Accepting new patients

Locations

19-21 Fair Lawn Ave
Fair Lawn, NJ 07410
Phone (201) 794-6868

19-21 Fair Lawn Ave
Ste 2A
Fair Lawn, NJ 07410
Phone (201) 543-1459

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

1124 E Ridgewood Ave
Ste 202
Ridgewood, NJ 07450
Phone (201) 689-9100

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

Interoperability endpoints

  • Direct secure messaging: rena.levykh-chase.1@5622.direct.athenahealth.com

Organizations & group practices 6

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 5

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1215085360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19-21 FAIR LAWN AVE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102331",
            "telephone_number": "201-791-8689",
            "fax_number": "201-791-2589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19-21 FAIR LAWN AVE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102331",
            "telephone_number": "201-791-8689",
            "fax_number": "201-791-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVYKH-CHASE",
        "first_name": "RENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA69109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8296804",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

Verify at the official NPI Registry.