Icc Medical Group, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

ICC MEDICAL GROUP, LLC

Practice address

721 Clifton Ave Ste 101
Clifton, NJ 07013-1880

Phone

(973) 343-5190

NPI assigned

Jan 21, 2025

Organization subpart

No

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

Authorized official

Name

Fernando BarreseNPI 1770797268

Title

Owner

Phone

(973) 343-5190

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fernando Barrese, D.C.

  • Chiropractor
  • Clifton, NJ
  • NPI 1770797268
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1215749908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 CLIFTON AVE STE 101",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131880",
            "telephone_number": "973-343-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 CLIFTON AVE STE 101",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131880",
            "telephone_number": "973-343-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICC MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "BARRESE",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-343-5190"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Piotr Huskowski, MD
• Nasrin Hwig, PA-C
• Jose D Ibarbia, M.D.
• Najat Ibrahim-Rosario, LCSW
• Shenouda Ibrahim, PA
• Jennifer C. Igbokwe, MD
• Muhammad Farhan Ijaz, MD
• Usman Ijaz
• Immediate Care PC
• Immedicenter

• Chiropractor in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.