Maria Jose Vasena Marengo, #39

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA09694700 Issued in NJ

Practice address

330 Lafayette Ave
Hawthorne, NJ 07506-2506

Phone

(973) 841-5112

Fax

(973) 826-5064

NPI assigned

Nov 4, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mvasenamarengo191555@ahs.direct-ci.com

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.

• St Josephs Medical Group PC

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1205425519
  Medicare reassignment NPD
• St. Joseph'S Healthcare, Inc.

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1497791297
  Medicare reassignment NPD
• HMH Hospitals Corporation

  • General Acute Care Hospital
  • Hackensack, NJ
  • NPI 1457456279
  NPD (past)
• St Josephs University Medical Center Inc.

  • General Acute Care Hospital
  • Paterson, NJ
  • NPI 1669462420
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1417201021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 MAPLE AVE",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074301233",
            "telephone_number": "201-529-1595",
            "fax_number": "973-826-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 LAFAYETTE AVE",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075062506",
            "telephone_number": "973-841-5112",
            "fax_number": "973-826-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASENA MARENGO",
        "first_name": "MARIA",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "#39",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-04",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA09694700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ehab Elias Tuppo, DO
• Ultima Sports and Spine LLC
• Van Dyk'S Senior Residence of Hawthorne, LLC
• Sydnee Vandyke
• Briseyda Eunise Vargas
• Thalia Vasiliades, D.O.
• Vein Pain & Spine Institute, LLC
• Yvelisse Velasquez-Ortiz, LAMFT
• Vital Health Centers
• Walgreen Co

• Pediatrics Physician in Hawthorne, NJ
• Providers in Hawthorne, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.