Individual provider Active NPI

Elizabeth Eapen, M.D.

  • Anatomic Pathology Physician
  • Ridgewood, NJ
National Provider Identifier
1407855216
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
25MA07780200 Issued in NJ
Practice address
223 North Van Dien Avenue
Department of Pathology
Ridgewood, NJ 07450-2736
Phone
(201) 447-8242
NPI assigned
Jul 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 25MA07780200 NJ Primary

Addresses

Primary practice location

223 North Van Dien Avenue
Department of Pathology
Ridgewood, NJ 07450-2736

Mailing address

12 Pharis PL
Upper Saddle River, NJ 07458-1408
Phone (201) 825-0883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040312001139 NY Practitioner - Pathology 3971492331 Reassigns benefits to 1 organization
I20071219000031 NJ Practitioner - Pathology 3971492331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ridgewood Pathology Group,PAGroup PAC ID 8527022904, 7 clinicians

Practice addresses (Care Compare)

223 N Van Dien Ave
Ridgewood, NJ 07450-2726
Phone (201) 447-8242

Hospital & facility affiliations

  • Valley Hospital Hospital, Paramus, NJ, CCN 310012

Merit-based Incentive Payment System (MIPS)

Final score
83.33 of 100Reported as group
Quality
66.67
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07780200NJMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Hematology Oncology Associates PC CurrentSince Apr 1, 2021 Accepting new patients
Saint Lukes Roosevelt Hospital - Pathology Dept Past Accepting new patients
Ac Rao PC PastSince Feb 23, 2021 Accepting new patients
Gastrointestinal Associates of Rockland, PC PastSince Jul 9, 1996 Accepting new patients
Beth Israel Medical Center Past Accepting new patients
University Pathology, P.C. Past Accepting new patients
Advantage Foot Care Associates, P.C. Past Accepting new patients
Gastrointestinal Care of Long Island PLLC PastSince Mar 10, 2025 Accepting new patients
Medical Associates of Englewood, PC PastSince Aug 15, 2022 Accepting new patients

Locations

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354

49 Route 347
Port Jefferson Station, NY 11776
Phone (631) 751-0000

48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540

Organizations & group practices 10

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 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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407855216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 PHARIS PL",
            "city": "UPPER SADDLE RIVER",
            "state": "NJ",
            "postal_code": "074581408",
            "telephone_number": "201-825-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 NORTH VAN DIEN AVENUE",
            "address_2": "DEPARTMENT OF PATHOLOGY",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502736",
            "telephone_number": "201-447-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAPEN",
        "first_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "NJ",
            "license": "25MA07780200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.