Individual provider Active NPI

Alicia Bacchus

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1255790192
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ15357100 Issued in NJ
Practice address
177 Fort Washington Ave
New York, NY 10032
Phone
(707) 344-2097
NPI assigned
Feb 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F341946 NY
Family Nurse Practitioner 363LF0000X 95003307 CA
Family Nurse Practitioner 363LF0000X 26NJ15357100 NJ Primary

Addresses

Primary practice location

177 Fort Washington Ave
New York, NY 10032

Mailing address

331 Newman Springs Road
BLDG. 2, Suite 220
Red Bank, NJ 07701
Phone (732) 807-0877

Other practice location 1

650 From Rd Ste 506
Paramus, NJ 07652-3517
Phone (551) 996-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171017000319 NY Practitioner - Nurse Practitioner 2961782958 Reassigns benefits to 5 organizations
I20251203004389 NJ Practitioner - Nurse Practitioner 2961782958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trustees of Columbia University in the City of New YorkGroup PAC ID 8527972546, 2,262 clinicians

Practice addresses (Care Compare)

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

Hospital & facility affiliations

  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95003307CAMDFamily Nurse Practitioner
26NJ15357100NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Aug 10, 2018 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Dec 1, 2025 Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 5, 2022 Accepting new patients
Essen Medical Associates, PC CurrentSince Oct 1, 2017 Accepting new patients
Bronx Medical Practice P.C. CurrentSince Oct 1, 2017 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Dec 1, 2025 Accepting new patients
Weill Medical College of Cornell CurrentSince Jul 5, 2022 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Aug 10, 2018 Accepting new patients
Essen Medical Associates, PC CurrentSince Oct 1, 2017 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Jul 10, 2018 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

650 From Rd
Ste 506
Paramus, NJ 07652
Phone (551) 996-1342

331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0514

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2015 Grand Concourse
#13202
Bronx, NY 10453

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387

525 E 68th St
#J130
New York, NY 10065
Phone (212) 746-3000

177 Fort Washington Ave
New York, NY 10032
Phone (212) 305-3090

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: abb9033@direct.nyp.org
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 11

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 7

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": "1456012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1255790192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS ROAD",
            "address_2": "BLDG. 2, SUITE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "07701",
            "telephone_number": "732-807-0877",
            "fax_number": "201-751-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 FORT WASHINGTON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10032",
            "telephone_number": "707-344-2097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 From Rd Ste 506",
            "address_purpose": "LOCATION",
            "city": "Paramus",
            "state": "NJ",
            "postal_code": "076523517",
            "country_code": "US",
            "telephone_number": "551-996-8100",
            "fax_number": "551-996-4140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACCHUS",
        "first_name": "ALICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-21",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F341946",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95003307",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ15357100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.