Individual provider Active NPI

Barry Ettinger, M.D.

  • Anesthesiology Physician
  • Englewood, NJ
National Provider Identifier
1245524933
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA09850400 Issued in NJ
Practice address
350 Engle St Dept of
Englewood, NJ 07631
Phone
(201) 894-3322
NPI assigned
May 31, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA09850400 NJ Primary
Anesthesiology Physician 207L00000X 267886 NY

Addresses

Primary practice location

350 Engle St Dept of
Englewood, NJ 07631

Mailing address

350 Engle St Dept of
Englewood, NJ 07631-1808
Phone (201) 834-3322

Other practice location 1

350 Engle St Dept Of
Englewood, NJ 07631
Phone (201) 894-3322

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160705001980 NJ Practitioner - Anesthesiology 2860706678 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Albert Einstein College of Medicine of Yeshiva University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastro-Surgi Center of New JerseyGroup PAC ID 9234125840, 9 clinicians
Morris Avenue Endoscopy LLCGroup PAC ID 8921074840, 13 clinicians
Northern Valley Anesthesiology PAGroup PAC ID 0749194868, 85 clinicians

Practice addresses (Care Compare)

1132 Spruce Dr
Mountainside, NJ 07092-2217
Phone (908) 317-0071

200 Sheffield St
Suite 101
Mountainside, NJ 07092-2315
Phone (908) 241-8900

350 Engle St
Englewood, NJ 07631-1808
Phone (201) 871-6073

Hospital & facility affiliations

  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09850400NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Healthcare Center PA CurrentSince Jul 19, 2017 Accepting new patients
Northern Valley Anesthesiology, P.a. Anesthesiology CurrentSince Jul 1, 2016 Accepting new patients
Gastro-Surgi Center of New Jersey Anesthesiology CurrentSince Apr 1, 2017 Accepting new patients
Morris Avenue Endoscopy LLC Anesthesiology CurrentSince Dec 6, 2020 Accepting new patients
Morris Avenue Endoscopy LLC Past Accepting new patients

Locations

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

511 Courtyard Dr
Hillsborough, NJ 08844
Phone (908) 218-1616

1132 Spruce Dr
Mountainside, NJ 07092
Phone (908) 317-0071

200 Sheffield St
Ste 101
Mountainside, NJ 07092
Phone (908) 241-8900

200 Sheffield St
Mountainside, NJ 07092
Phone (908) 241-8900

Organizations & group practices 5

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 1

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": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1245524933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 ENGLE ST DEPT OF",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311808",
            "telephone_number": "201-834-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ENGLE ST DEPT OF",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "07631",
            "telephone_number": "201-894-3322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Engle St Dept Of",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "NJ",
            "postal_code": "07631",
            "country_code": "US",
            "telephone_number": "201-894-3322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETTINGER",
        "first_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-31",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA09850400",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "267886",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.