Individual provider Active NPI

Ellen E Urrutia, MD

  • Cardiovascular Disease Physician
  • Glen Ridge, NJ
National Provider Identifier
1629046388
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA06255200 Issued in NJ
Practice address
946 Bloomfield Avenue
Glen Ridge, NJ 07028
Phone
(973) 743-1121
Fax
(973) 743-2627
NPI assigned
Mar 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MA06255200 NJ Primary

Addresses

Primary practice location

946 Bloomfield Avenue
Glen Ridge, NJ 07028

Mailing address

946 Bloomfield Avenue
Main Level
Glen Ridge, NJ 07028
Phone (973) 743-1121

Other identifiers 1

IdentifierTypeStateIssuer
5131103MedicaidNJ

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
I20060117000461 NJ Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7618991746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

1 Clara Maass Dr
Belleville, NJ 07109-3550
Phone (973) 450-2000

24 Elm St
Harrington Park, NJ 07640-1902
Phone (201) 451-1601

946 Bloomfield Ave
Glen Ridge, NJ 07028-1308
Phone (201) 743-1121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC CurrentSince Dec 15, 2011 Accepting new patients

Locations

180 Engle St
Englewood, NJ 07631
Phone (201) 567-2050

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

946 Bloomfield Ave
Glen Ridge, NJ 07028
Phone (973) 376-3259

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

Interoperability endpoints

  • Direct secure messaging: eurrutia260386@epicdirect.rwjbh.org
  • Direct secure messaging: eurrutia236567@direct.englewoodhealth.org

Organizations & group practices 1

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 4

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1629046388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "946 BLOOMFIELD AVENUE",
            "address_2": "MAIN LEVEL",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "07028",
            "telephone_number": "973-743-1121",
            "fax_number": "973-743-2627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "946 BLOOMFIELD AVENUE",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "07028",
            "telephone_number": "973-743-1121",
            "fax_number": "973-743-2627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URRUTIA",
        "first_name": "ELLEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA06255200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5131103",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ridge, NJ

Sources for this page

Verify at the official NPI Registry.