NPIMap

Organization Active NPI

Northern Valley Anesthesiology, P.a.

  • Anesthesiology Physician
  • Englewood, NJ
National Provider Identifier
1245289487
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
NORTHERN VALLEY ANESTHESIOLOGY, P.A.
Practice address
350 Engle St
Englewood, NJ 07631-1808
Phone
(201) 871-6073
Fax
(201) 871-0619
NPI assigned
May 7, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Stacey Michelle Wilson
Title
Director
Phone
(865) 985-7114

Practitioners 186

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

View all 186

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031113000519 NJ Part B Supplier - Clinic/Group Practice 0749194868 Receives reassigned benefits from 134 practitioners
Practice locations: Englewood, NJ

National Provider Directory

National Provider Directory

Locations

1700 Galloping Hill Rd
Kenilworth, NJ 07033
Phone (908) 241-8900

785 W Montauk Hwy
West Babylon, NY 11704
Phone (631) 587-7373

1500 Jericho Tpke
Westbury, NY 11590
Phone (516) 277-8400

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

350 Engle St
Englewood, NJ 07631-1808

Mailing address

265 Brookview Centre Way Ste 203
Knoxville, TN 37919-4053
Phone (865) 985-7114

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
01357648OtherNYNEW YORK STATE MEDICAID
2547406MedicaidNJ
CM1039OtherNJRAILROAD MEDICARE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 5, 2026.

{
    "created_epoch": "1146960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780617600000",
    "number": "1245289487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 BROOKVIEW CENTRE WAY STE 203",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194053",
            "telephone_number": "865-985-7114",
            "fax_number": "865-692-5867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311808",
            "telephone_number": "201-871-6073",
            "fax_number": "201-871-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN VALLEY ANESTHESIOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-07",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "865-985-7114"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE MEDICAID",
            "identifier": "01357648",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2547406",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CM1039",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; 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.