Individual provider Active NPI

Stefanie Vaimakis, M.D.

  • Surgery Physician
  • Englewood, NJ
National Provider Identifier
1396802633
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Practice address
350 Engle St
5TH Floor
Englewood, NJ 07631-1808
Phone
(201) 227-5289
Fax
(201) 227-5591
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NJ Primary

Addresses

Primary practice location

350 Engle St
5TH Floor
Englewood, NJ 07631-1808

Mailing address

PO Box 8157
Englewood, NJ 07631-8157
Phone (201) 227-5289

Other names 1

  • Dr. Stefanie Cravioto Former name

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
I20040423000412 NJ Practitioner - General Surgery 8325034432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

690 Kinderkamack Rd
Suite 202
Oradell, NJ 07649-1524
Phone (201) 530-1900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MAO7456100NJMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palisades Surgical Associates, P.C. Surgery CurrentSince Nov 17, 2024 Accepting new patients
Bergen Laparoscopy & Bariatrics Associates LLC Surgery Past Accepting new patients
Englewood Laparoscopic & Bariatric Associates, LLC Surgery Past Accepting new patients

Locations

350 Engle St
#3W
Englewood, NJ 07631
Phone (201) 227-5526

350 Engle St
#2E
Englewood, NJ 07631
Phone (201) 227-5533

350 Engle St
Fl 5
Englewood, NJ 07631
Phone (201) 568-5250

690 Kinderkamack Rd
Ste 202
Oradell, NJ 07649
Phone (201) 530-1900

Interoperability endpoints

  • Direct secure messaging: stefanie.vaimakis.1@32759.direct.athenahealth.com

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 4

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1396802633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8157",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076318157",
            "telephone_number": "201-227-5289",
            "fax_number": "201-227-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 ENGLE ST",
            "address_2": "5TH FLOOR",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311808",
            "telephone_number": "201-227-5289",
            "fax_number": "201-227-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAIMAKIS",
        "first_name": "STEFANIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFANIE",
            "last_name": "CRAVIOTO",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Englewood, NJ

Sources for this page

Verify at the official NPI Registry.