NPIMap

Individual provider Active NPI

Alfonso Ciervo, MD

  • Specialist
  • Eatontown, NJ
National Provider Identifier
1457346918
Registry record updated Sep 13, 2007
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Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MA06756800 Issued in NJ
Practice address
142 Highway 35
Suite 106a
Eatontown, NJ 07724-3427
Phone
(732) 380-1222
NPI assigned
Sep 12, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MA06756800 NJ Primary

Addresses

Primary practice location

142 Highway 35
Suite 106a
Eatontown, NJ 07724-3427

Mailing address

4 Crape Myrtle Dr
Holmdel, NJ 07733-1529
Phone (732) 380-1222

Other identifiers 9

IdentifierTypeStateIssuer
0035378MedicaidNJ
2K7795OtherNJHEALTHNET ID #
5337R1OtherNJBCBS OF NY ID #
2313631000OtherNJAMERIHEALTH ID #
7790588OtherNJAETNA PPO ID #
8221858OtherNJGHI PPO ID #
3732796OtherNJAETNA HMO ID #
97662OtherNJAMERICAID / AMERIGROUP #
P00158098OtherNJRAILROAD MEDICARE ID #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040412000305 NJ Practitioner - Vascular SurgeryPractitioner - General Surgery 1951395201 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
State University of Ny Upstate Medical University, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

966 State Route 36
Hazlet, NJ 07730-1700
Phone (800) 838-3841

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.38 of 100Reported as individual
Quality
100
Improvement activities
40
Cost
81.26

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Colonoscopy1-10
Hernia repair - groin (open)1-10
Pacemaker insertion or repair1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Varicose vein removal1-10
Melanoma (skin cancer) excision29
Leg revascularization (restoring blood flow)60
Removal of tissue50
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Vascular Group Specialist CurrentSince May 1, 2004 Accepting new patients
Vascular Access Center of Trenton LLC PastSince Feb 1, 2017 Accepting new patients

Locations

142 Highway 35
Eatontown, NJ 07724
Phone (732) 389-5004

142 Highway 35
Ste 106
Eatontown, NJ 07724
Phone (682) 235-0825

142 Highway 35
Ste 106A
Eatontown, NJ 07724
Phone (732) 380-1222

966 State Route 36
Hazlet, NJ 07730
Phone (732) 389-3500

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189641600000",
    "number": "1457346918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CRAPE MYRTLE DR",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331529",
            "telephone_number": "732-380-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 HIGHWAY 35",
            "address_2": "SUITE 106A",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077243427",
            "telephone_number": "732-380-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIERVO",
        "first_name": "ALFONSO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2007-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA06756800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0035378",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET ID #",
            "identifier": "2K7795",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NY ID #",
            "identifier": "5337R1",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH ID #",
            "identifier": "2313631000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO ID #",
            "identifier": "7790588",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PPO ID #",
            "identifier": "8221858",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO ID #",
            "identifier": "3732796",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAID / AMERIGROUP #",
            "identifier": "97662",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID #",
            "identifier": "P00158098",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatontown, NJ

Sources for this page

Verify at the official NPI Registry.