Nicholas Joseph Bevilacqua, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

25MD00304300 Issued in NJ

Practice address

730 Palisade Ave
Teaneck, NJ 07666-3144

Phone

(201) 353-9000

NPI assigned

Sep 23, 2006

Sex

Male

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holy Name Primary Care and Specialty Associates PCGroup PAC ID 4082847447, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008
• Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045
• Kessler Rehab Center Inpatient rehabilitation facility, West Orange, NJ, CCN 313025

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nicholasbevilacqua@njo.allscriptsdirect.net
• Direct secure messaging: nbevilacqua189430@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.

• Holy Name Primary Care and Specialty Associates, PC

  • Psychiatry Physician
  • Teaneck, NJ
  • NPI 1104256130
  Medicare reassignment Care Compare group NPD
• North Jersey Orthopaedic Specialists P.a.

  • Orthopaedic Surgery Physician
  • Teaneck, NJ
  • NPI 1396787990
  Medicare reassignment
• Closter Internal Medicine, P.C.

  • Internal Medicine Physician
  • Closter, NJ
  • NPI 1467584284
  NPD (past)
• Des Moines Anesthesiologists PC

  • Anesthesiology Physician
  • Des Moines, IA
  • NPI 1073612016
  NPD (past)
• Rosalind Franklin University of Medicine and Science

  • Clinical Medical Laboratory
  • North Chicago, IL
  • NPI 1073622254
  NPD (past)

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

• Englewood Hospital and Medical Center

  • General Acute Care Hospital
  • Englewood, NJ
  • NPI 1083612881
  Care Compare affiliation
• Holy Name Hospital Regional Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Teaneck, NJ
  • NPI 1043389349

  Hospital

  Care Compare affiliation
• Holy Name Medical Center Inc.

  • General Acute Care Hospital
  • Teaneck, NJ
  • NPI 1104859131
  Care Compare affiliation
• Kessler Institute for Rehabilitation Inc

  • Rehabilitation Hospital
  • West Orange, NJ
  • NPI 1013919620

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1487754131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 PALISADE AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663144",
            "telephone_number": "201-353-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 PALISADE AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663144",
            "telephone_number": "201-353-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEVILACQUA",
        "first_name": "NICHOLAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-23",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00304300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey A Berman, M.D.
• Sophia Yanikah Bernard, PMHNP
• Jason Bernath, MS, OTR/L
• Bess Berger Nutrition Consulting, LLC
• Bethel Health Care LLC
• BF Dental Professionals PC
• Gautam Bhasin, PSYD
• Kiran Bhat, M.D.
• Amit M Bhatt, PHARMD, RPH
• Poonam K Bhavsar

• Foot & Ankle Surgery Podiatrist in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Foot & Ankle Surgery Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.
• 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.

Verify at the official NPI Registry.