Individual provider Active NPI

Andrey Filimonov, MD

  • Otolaryngology Physician
  • Newark, NJ
National Provider Identifier
1386175974
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
25MA11859800 Issued in NJ
Practice address
90 Bergen St Ste 8100
Newark, NJ 07103-2425
Phone
(973) 972-2548
NPI assigned
Mar 24, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 25MA11859800 NJ Primary

Addresses

Primary practice location

90 Bergen St Ste 8100
Newark, NJ 07103-2425

Mailing address

67 Carol PL
Wayne, NJ 07470-2925
Phone (973) 460-2585

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
I20230728001278 NJ Practitioner - Otolaryngology 6507102837 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2017
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

30 Bergen St
Newark, NJ 07107-3000
Phone (973) 972-0037

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc Otolaryngology CurrentSince Aug 1, 2023 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Aug 1, 2023 Accepting new patients
Signify Health Medical Associates of New Jersey, LLC CurrentSince Jul 26, 2023 Accepting new patients
University Physician Associates of New Jersey Inc Past Accepting new patients

Locations

377 Jersey Ave
Ste 220
Jersey City, NJ 07302
Phone (201) 309-2380

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

90 Bergen St
#8100
Newark, NJ 07103
Phone (973) 972-2323

30 Bergen St
Bldg 12
Newark, NJ 07107
Phone (973) 972-0037

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

30 Bergen St
#12
Newark, NJ 07107
Phone (973) 972-0037

90 Bergen St
Ste 8100
Newark, NJ 07103
Phone (973) 972-0037

116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 285-3094

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 4

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 5

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": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1386175974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 CAROL PL",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702925",
            "telephone_number": "973-460-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST STE 8100",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILIMONOV",
        "first_name": "ANDREY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": "25MA11859800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.