Individual provider Active NPI

Stephen Lee Viviano, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Livingston, NJ
National Provider Identifier
1356760664
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
MD61015353 Issued in WA
Practice address
200 S Orange Ave Ste 295
Livingston, NJ 07039-5817
Phone
(201) 449-1000
Fax
(201) 399-2433
NPI assigned
Apr 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X MD61015353 WA Primary
Plastic and Reconstructive Surgery Physician 2086S0122X 25MA10630300 NJ

Addresses

Primary practice location

200 S Orange Ave Ste 295
Livingston, NJ 07039-5817

Mailing address

200 S Orange Ave Ste 295
Livingston, NJ 07039-5817
Phone (201) 449-1000

Other practice location 1

1959 NE Pacific St
Seattle, WA 98195-2425
Phone (206) 520-5000

Other identifiers 1

IdentifierTypeStateIssuer
1356760664MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200414000917 WA Practitioner - Plastic and Reconstructive Surgery 5496185548 Reassigns benefits to 1 organization
I20210514000052 NJ Practitioner - Plastic and Reconstructive Surgery 5496185548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Texas Medical School at Houston, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Coast Advanced Plastic Surgery LLCGroup PAC ID 8628249786, 12 clinicians

Practice addresses (Care Compare)

200 S Orange Ave
Livingston, NJ 07039-5817
Phone (201) 449-1000

Hospital & facility affiliations

  • Cooperman Barnabas Medical Center Hospital, Livingston, NJ, CCN 310076
  • Clara Maass Medical Center Hospital, Belleville, NJ, CCN 310009
  • Kessler Rehab Center Inpatient rehabilitation facility, West Orange, NJ, CCN 313025

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy16
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
East Coast Advanced Plastic Surgery LLC CurrentSince May 1, 2021 Accepting new patients
The Association of Chrmc and University Physicians CurrentSince Apr 3, 2020 Accepting new patients
Association of CHMC and University Physicians CurrentSince Apr 3, 2020 Accepting new patients

Locations

639 E Ocean Ave
Ste 308
Ocean Ridge, FL 33435

200 S Orange Ave
Ste 295
Livingston, NJ 07039
Phone (201) 449-1000

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

Organizations & group practices 3

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 3

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": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1356760664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S ORANGE AVE STE 295",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395817",
            "telephone_number": "201-449-1000",
            "fax_number": "201-399-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S ORANGE AVE STE 295",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395817",
            "telephone_number": "201-449-1000",
            "fax_number": "201-399-2433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1959 NE Pacific St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981952425",
            "country_code": "US",
            "telephone_number": "206-520-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIVIANO",
        "first_name": "STEPHEN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "WA",
            "license": "MD61015353",
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NJ",
            "license": "25MA10630300",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356760664",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.