Ivan Bilbao-Lavieja, PA
Individual provider Active NPI Physician Assistant · Maywood, NJ
NPI 1477593820 · NPPES record last updated Dec 11, 2024
Key facts
- NPI
- 1477593820
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 25MP00179900 (NJ)
- Practice address
- 113 W Essex St
Ste 201
Maywood, NJ 07607-1023 - Phone
- (201) 251-7725
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Hackensack Meridian Health Medical Group - Specialty Care PC
Practice addresses (Care Compare)
113 W Essex St
Suite 201
Maywood, NJ 07607-1023
Phone (201) 251-7725
30 Prospect Ave
Hackensack, NJ 07601-1915
Hospital & facility affiliations
- Hackensack University Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.33 of 100
- Quality
- 66.38
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.39
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20071023000634 | NJ | Practitioner - Physician Assistant | 3779689666 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009941 | NY | MD | Veterinarian |
| 25MP00179900 | NJ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current |
Accepting new patients | |
| Meridian Medical Group - Specialty Care, PC | Past | Accepting new patients | |
| Hackensack Meridian Health Medical Group - Complex Care PC | Past | Accepting new patients | |
| The Parkway Hospital | Past | Accepting new patients |
Locations
30 Prospect Ave
#3
Hackensack, NJ 07601
Phone (201) 996-5226
30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066
113 W Essex St
Ste 201
Maywood, NJ 07607
Phone (201) 226-0145
Interoperability endpoints
- ivan.bilbao-lavieja@direct.hackensackmeridian.org
- https://fhir4.healow.com/fhir/r4/IHJHBD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 009941 | NY | |
| Physician Assistant | 363A00000X | 25MP00179900 | NJ | Yes |
Addresses
Primary practice location
113 W Essex St
Ste 201
Maywood, NJ 07607-1023
Mailing address
331 Newman Springs Rd
BLDG 2, Ste 220
Red Bank, NJ 07701-5688
Other practice location 1
7035 113th St
Forest Hills, NY 11375-4651
Phone (718) 990-4648
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00403304 | Other | NY | RAILROAD |
Other providers in Maywood, NJ
- Kim R. Arrington
- Basel Baghal
- Jaymie A Barette
- Chelsea Linda Bernal
- Patricia Betty
- Anna Blazejowskyj
- Marissa Bocchiaro
- Bonleven Healthcare
- Ben Boonstra
- Borough of Maywood
All providers in Maywood, NJ · Physician Assistant in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.