Individual provider Active NPI

Alfonso Waller, MD

  • Cardiovascular Disease Physician
  • Newark, NJ
National Provider Identifier
1326219577
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA08557800 Issued in NJ
Practice address
90 Bergen St
Suite 3500
Newark, NJ 07103-2425
Phone
(973) 972-2573
NPI assigned
Mar 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MA08557800 NJ Primary

Addresses

Primary practice location

90 Bergen St
Suite 3500
Newark, NJ 07103-2425

Mailing address

185 S Orange Ave
Newark, NJ 07103-2757
Phone (973) 972-4731

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address awaller5991@direct-uhnj.org Health Information Exchange (HIE) University Hospital

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
I20140822001221 NJ Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8325286354 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

140 Bergen St
Newark, NJ 07103-2425
Phone (973) 972-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group, PC CurrentSince Sep 19, 2023 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Oct 1, 2023 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Jul 1, 2014 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Oct 1, 2023 Accepting new patients
University Hospital Past Accepting new patients
University Physician Associates of New Jersey Inc Past Accepting new patients

Locations

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

90 Bergen St
Ste 3500
Newark, NJ 07103
Phone (973) 972-2573

30 Bergen St
Rm 1205
Newark, NJ 07107
Phone (973) 972-0037

201 Lyons Ave
Ste L5
Newark, NJ 07112
Phone (973) 926-3500

90 Bergen St
Newark, NJ 07103
Phone (973) 972-0037

140 Bergen St
Newark, NJ 07103
Phone (973) 972-0320

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

3 Executive Dr
Ste 400
Somerset, NJ 08873
Phone (732) 369-5949

223 Monmouth Rd
West Long Branch, NJ 07764
Phone (732) 229-3838

Organizations & group practices 6

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 4

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": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1326219577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 S ORANGE AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032757",
            "telephone_number": "973-972-4731",
            "fax_number": "973-972-8927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST",
            "address_2": "SUITE 3500",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "ALFONSO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-17",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA08557800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awaller5991@direct-uhnj.org",
            "affiliation": "Y",
            "affiliationName": "University Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "150 Bergen St",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071032496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.