Active NPI
Eric Y. Bentolila, MD
- Specialist
- Ridgewood, NJ
National Provider Identifier
1487726675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 25MA07057600
- Practice address
- 615 Franklin Turnpike
Ridgewood, NJ 07450 - Phone
- (201) 447-1700
- Fax
- (201) 447-9386
- NPI assigned
- Nov 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 25MA07057600 | NJ | Primary |
Addresses
Primary practice location
615 Franklin Turnpike
Ridgewood, NJ 07450
Mailing address
615 Franklin Turnpike
First Floor
Ridgewood, NJ 07450
Phone (201) 447-1700
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 768D51 | Other | NJ | EMPIRE BCBS |
| 010070576NJ01 | Other | NJ | ANTHEM HEALTH # |
| 0864547000 | Other | NJ | AMERIHEALTH # |
| P3602721 | Other | NJ | OXFORD |
| 2K8579 | Other | NJ | HEALTHNET |
| 3839722 | Other | NJ | AETNA HMO |
| 7488147 | Other | NJ | AETNA PPO# |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
16 Pocono Rd
Denville, NJ 07834-2901
Phone (973) 784-3935
Hospital & facility affiliations
- Valley Hospital
- Hackensack University Medical Center
- Englewood Hospital and Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifeline Medical Associates, LLC | Current | Accepting new patients | |
| The Valley Hospital Inc. | Past | Accepting new patients |
Locations
1160 Kennedy Blvd
Ste C
Bayonne, NJ 07002
Phone (201) 823-0303
16 Pocono Rd
Frnt
Denville, NJ 07834
Phone (973) 784-3935
100 Campus Dr
Ste 405
Florham Park, NJ 07932
Phone (800) 845-2785
Interoperability endpoints
- eric.bentolila.1@27010.direct.athenahealth.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
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.
-
- Obstetrics & Gynecology Physician
- Florham Park, NJ
- NPI 1821041617
NJ
-
- General Acute Care Hospital
- Paramus, NJ
- NPI 1013912633
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Englewood, NJ
- NPI 1083612881
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454371200000",
"number": "1487726675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 FRANKLIN TURNPIKE",
"address_2": "FIRST FLOOR",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "07450",
"telephone_number": "201-447-1700",
"fax_number": "201-447-9386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 FRANKLIN TURNPIKE",
"city": "RIDGEWOOD",
"state": "NJ",
"postal_code": "07450",
"telephone_number": "201-447-1700",
"fax_number": "201-447-9386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENTOLILA",
"first_name": "ERIC",
"middle_name": "Y.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-14",
"last_updated": "2016-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "25MA07057600",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BCBS",
"identifier": "768D51",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM HEALTH #",
"identifier": "010070576NJ01",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH #",
"identifier": "0864547000",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P3602721",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "2K8579",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "3839722",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO#",
"identifier": "7488147",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ridgewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.