Individual provider Active NPI

Ryan D Visbeen, MSN, APRN, AGPCNP-BC

  • Primary Care Nurse Practitioner
  • Hackensack, NJ
National Provider Identifier
1376179283
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
26NJ01028800 Issued in NJ
Practice address
360 Essex St Ste 301
Hackensack, NJ 07601-8566
Phone
(201) 646-0110
NPI assigned
Mar 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 26NJ01028800 NJ Primary

Addresses

Primary practice location

360 Essex St Ste 301
Hackensack, NJ 07601-8566

Mailing address

360 Essex St Ste 301
Hackensack, NJ 07601-8566
Phone (201) 646-0110

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200514001636 NJ Practitioner - Nurse Practitioner 0244661809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BSD Nephrology and Hypertension PAGroup PAC ID 4082644158, 6 clinicians

Practice addresses (Care Compare)

360 Essex St
Suite 304
Hackensack, NJ 07601-8566
Phone (201) 646-0110

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
BSD NJ Medical LLC CurrentSince Jun 1, 2020 Accepting new patients
BSD Nephrology and Hypertension PA CurrentSince Jun 1, 2020 Accepting new patients

Locations

360 Essex St
Ste 301
Hackensack, NJ 07601
Phone (201) 646-0110

360 Essex St
Ste 304
Hackensack, NJ 07601
Phone (201) 646-0110

Interoperability endpoints

  • Direct secure messaging: ryan.visbeen@direct.davitaphysiciansolutions.com

Organizations & group practices 2

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 2

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": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584921600000",
    "number": "1376179283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 ESSEX ST STE 301",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076018566",
            "telephone_number": "201-646-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 ESSEX ST STE 301",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076018566",
            "telephone_number": "201-646-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISBEEN",
        "first_name": "RYAN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "MSN, APRN, AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NJ",
            "license": "26NJ01028800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.