Ivan David Winter, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA05367900 Issued in NJ

Practice address

9226 Kennedy Blvd FL 2
North Bergen, NJ 07047-5312

Phone

(201) 863-3055

Fax

(201) 863-5744

NPI assigned

Jul 30, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1265788053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9226 KENNEDY BLVD",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475312",
            "telephone_number": "973-723-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9226 KENNEDY BLVD FL 2",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475312",
            "telephone_number": "201-863-3055",
            "fax_number": "201-863-5744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTER",
        "first_name": "IVAN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-30",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05367900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in North Bergen, NJ
• Providers in North Bergen, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.