Individual provider Active NPI

Carolyn T Peart, M.D.

  • Family Medicine Physician
  • River Vale, NJ
National Provider Identifier
1356889422
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA11070200 Issued in NJ
Practice address
645 Westwood Ave FL 2
River Vale, NJ 07675-6295
Phone
(201) 666-1000
NPI assigned
Feb 8, 2017
Last updated
Dec 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MA11070200 NJ Primary

Addresses

Primary practice location

645 Westwood Ave FL 2
River Vale, NJ 07675-6295

Mailing address

6045 Kennedy Blvd Ste B
North Bergen, NJ 07047-3246
Phone (201) 854-4255

Other practice location 1

6045 Kennedy Blvd Ste B
North Bergen, NJ 07047-3246
Phone (201) 854-4255

Other identifiers 1

IdentifierTypeStateIssuer
0800473MedicaidNJ

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
I20210820001425 NJ Practitioner - Family Practice 8729483276 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

645 Westwood Ave
FL 2
River Vale, NJ 07675-6295
Phone (201) 666-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11070200NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Primary Care PC Family Medicine CurrentSince Sep 1, 2021 Accepting new patients
Medical Associates of Englewood, PC CurrentSince Sep 15, 2023 Accepting new patients
Meridian Medical Group - Specialty Care, PC Family Medicine Past Accepting new patients

Locations

985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600

180 Engle St
Englewood, NJ 07631
Phone (201) 567-2050

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

7650 River Rd
Ste 300
North Bergen, NJ 07047
Phone (201) 224-8831

300 Perrine Rd
Ste 324
Old Bridge, NJ 08857
Phone (732) 753-9890

645 Westwood Ave
Fl 2
River Vale, NJ 07675
Phone (201) 666-1000

Interoperability endpoints

  • Direct secure messaging: carolyn.peart@direct.hackensackmeridian.org
  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1486512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1356889422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6045 KENNEDY BLVD STE B",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070473246",
            "telephone_number": "201-854-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 WESTWOOD AVE FL 2",
            "city": "RIVER VALE",
            "state": "NJ",
            "postal_code": "076756295",
            "telephone_number": "201-666-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6045 Kennedy Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "North Bergen",
            "state": "NJ",
            "postal_code": "070473246",
            "country_code": "US",
            "telephone_number": "201-854-4255",
            "fax_number": "201-453-0325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEART",
        "first_name": "CAROLYN",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-08",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA11070200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0800473",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in River Vale, NJ

Sources for this page

Verify at the official NPI Registry.