Ridgewood Infectious Disease Associates, PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA03896800 Issued in NJ

Legal business name

RIDGEWOOD INFECTIOUS DISEASE ASSOCIATES, PA

Practice address

141 Dayton St
Suite 201
Ridgewood, NJ 07450-4496

Phone

(201) 447-6468

Fax

(201) 447-3189

NPI assigned

Jun 28, 2007

Organization subpart

No

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

Authorized official

Name

Gary G Knackmuhs, M.D.

Title

Delegated Official

Phone

(201) 447-6468

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lucy Cheng, M.D.

  • Infectious Disease Physician
  • Ridgewood, NJ
  • NPI 1942509625
  Medicare reassignment Care Compare group NPD
• Neil Gaffin, M.D.

  • Infectious Disease Physician
  • Ridgewood, NJ
  • NPI 1649259045
  Medicare reassignment Care Compare group NPD
• Carol Ann O'Hagan Sotsky, M.D.

  • Infectious Disease Physician
  • Ridgewood, NJ
  • NPI 1710966064
  Medicare reassignment Care Compare group NPD
• Simon John Tsiouris, M.D.

  • Infectious Disease Physician
  • Ridgewood, NJ
  • NPI 1114085040
  Medicare reassignment Care Compare group NPD
• Deborah E Rudin, M.D.

  • Infectious Disease Physician
  • Ridgewood, NJ
  • NPI 1013974971
  NPD (past)

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1487851903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 DAYTON ST",
            "address_2": "SUITE 201",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504496",
            "telephone_number": "201-447-6468",
            "fax_number": "201-447-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 DAYTON ST",
            "address_2": "SUITE 201",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504496",
            "telephone_number": "201-447-6468",
            "fax_number": "201-447-3189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEWOOD INFECTIOUS DISEASE ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "KNACKMUHS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "201-447-6468",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA03896800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO GROUP #",
            "identifier": "1084470",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO GROUP #",
            "identifier": "7117748",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3240509",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR GROUP #",
            "identifier": "CM1037",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ridgewood Dentistry, LLC
• Ridgewood ENT & Dermatology
• Ridgewood Eye Care & Wear LLC
• Ridgewood Foot Center
• Ridgewood House of Wellness LLC
• Ridgewood Institute for Integral Psychotherapy
• Ridgewood Medical Associates
• Ridgewood Ophthalmology, PC
• Ridgewood Orthopedic Group, LLC
• Ridgewood Pathology Group,PA

• Specialist in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.