Individual provider Active NPI

Yudi Camacho

  • Endocrinology, Diabetes & Metabolism Physician
  • West New York, NJ
National Provider Identifier
1417477340
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
25MA11525000 Issued in NJ
Practice address
435 57TH St
West New York, NJ 07093-2119
Phone
(201) 520-1069
NPI assigned
Jun 21, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X 25MA11525000 NJ Primary

Addresses

Primary practice location

435 57TH St
West New York, NJ 07093-2119

Mailing address

435 57TH St
West New York, NJ 07093-2119
Phone (201) 520-1069

Other practice location 1

2 Journal Sq
Jersey City, NJ 07306-4006
Phone (551) 325-2662

Other identifiers 1

IdentifierTypeStateIssuer
0864421MedicaidNJ

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
I20221123000564 NJ Practitioner - EndocrinologyPractitioner - Internal Medicine 6002284007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

435 59TH St
West New York, NJ 07093-2107
Phone (201) 295-1456

Hospital & facility affiliations

  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11525000NJMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC Multi-Specialty CurrentSince Aug 15, 2022 Accepting new patients
Raffaele Gibilisco,MD,PA Multi-Specialty PastSince Aug 15, 2022 Accepting new patients

Locations

180 Engle St
Englewood, NJ 07631
Phone (201) 567-2050

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

2 Journal Square Plz
Fl 3
Jersey City, NJ 07306
Phone (201) 894-3636

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

435 59th St
West New York, NJ 07093
Phone (201) 295-1456

435 57th St
West New York, NJ 07093
Phone (201) 295-1456

Organizations & group practices 2

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": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1417477340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 57TH ST",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070932119",
            "telephone_number": "201-520-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 57TH ST",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070932119",
            "telephone_number": "201-520-1069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Journal Sq",
            "address_purpose": "LOCATION",
            "city": "Jersey City",
            "state": "NJ",
            "postal_code": "073064006",
            "country_code": "US",
            "telephone_number": "551-325-2662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMACHO",
        "first_name": "YUDI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA11525000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0864421",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West New York, NJ

Sources for this page

Verify at the official NPI Registry.