Individual provider Active NPI

Vincent Angelo Graziano, M.D.

  • Nephrology Physician
  • Wayne, NJ
National Provider Identifier
1578554796
Registry record updated Jul 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MA37894 Issued in NJ
Practice address
246 Hamburg Tpke
Suite 207
Wayne, NJ 07470-2150
Phone
(973) 653-3366
Fax
(973) 653-3365
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MA37894 NJ Primary

Addresses

Primary practice location

246 Hamburg Tpke
Suite 207
Wayne, NJ 07470-2150

Mailing address

246 Hamburg Tpke
Suite 207
Wayne, NJ 07470-2150
Phone (973) 653-3366

Other identifiers 13

IdentifierTypeStateIssuer
1042675OtherNJHORIZON NJ HEALTH
1606301MedicaidNJ
1993694OtherNJUNITED HEALTHCARE
5710244OtherNJGHI
91001442300OtherNJAMERICHOICE
0072037000OtherNJAMERIHEALTH
CC8414OtherNJRAILROAD MEDICARE
0934255OtherNJCIGNA
221963249OtherNJQUALCARE
4300272OtherNJAETNA
11007OtherNJAMERIGROUP
OK2308OtherNJHEALTHNET
BS671OtherNJOXFORD

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041019000845 NJ Practitioner - Nephrology 7214848852 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Georgetown University School of Medicine, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Jersey Nephrology Assoc. PAGroup PAC ID 7315908167, 15 clinicians

Practice addresses (Care Compare)

246 Hamburg Tpke
Suite 207
Wayne, NJ 07470-2160
Phone (973) 653-3366

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA37894NJMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Healthcare, Inc. CurrentSince Sep 4, 2017 Accepting new patients
St. Joseph's Dialysis , LLC PastSince Jan 1, 2010 Accepting new patients

Locations

703 Main St
Bldg 400
Paterson, NJ 07503
Phone (973) 754-2054

703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

Organizations & group practices 3

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215216000000",
    "number": "1578554796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 HAMBURG TPKE",
            "address_2": "SUITE 207",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702150",
            "telephone_number": "973-653-3366",
            "fax_number": "973-653-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 HAMBURG TPKE",
            "address_2": "SUITE 207",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702150",
            "telephone_number": "973-653-3366",
            "fax_number": "973-653-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAZIANO",
        "first_name": "VINCENT",
        "middle_name": "ANGELO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2008-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "MA37894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1042675",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1606301",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1993694",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "5710244",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "91001442300",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0072037000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC8414",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0934255",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCARE",
            "identifier": "221963249",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4300272",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "11007",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "OK2308",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "BS671",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

Verify at the official NPI Registry.