Active NPI
Heather Bryan
- Surgical Physician Assistant
- Cliffside Park, NJ
National Provider Identifier
1376964288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 25MP00320300
- Practice address
- 663 Palisade Ave
Cliffside Park, NJ 07010-3012 - Phone
- (201) 943-9100
- Fax
- (201) 943-7308
- NPI assigned
- Dec 18, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 25MP00320300 | NJ | Primary |
Addresses
Primary practice location
663 Palisade Ave
Cliffside Park, NJ 07010-3012
Mailing address
111 Galway PL
Teaneck, NJ 07666-3640
Phone (201) 833-9500
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
222 Cedar LN
Suite 120
Teaneck, NJ 07666-4311
Phone 2018365332219
Hospital & facility affiliations
- Holy Name Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
-
- Orthopaedic Surgery Physician
- Teaneck, NJ
- NPI 1144406521
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Teaneck, NJ
- NPI 1043389349
Hospital
-
- General Acute Care Hospital
- Teaneck, NJ
- NPI 1104859131
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387324800000",
"number": "1376964288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 GALWAY PL",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076663640",
"telephone_number": "201-833-9500",
"fax_number": "201-862-0095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "663 PALISADE AVE",
"city": "CLIFFSIDE PARK",
"state": "NJ",
"postal_code": "070103012",
"telephone_number": "201-943-9100",
"fax_number": "201-943-7308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYAN",
"first_name": "HEATHER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-18",
"last_updated": "2013-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NJ",
"license": "25MP00320300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cliffside Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.