Individual provider Active NPI

Kevin Vasquez

  • Family Medicine Physician
  • Paterson, NJ
National Provider Identifier
1669001426
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA11891200 Issued in NJ
Practice address
St. Joseph'S University Medical Hospital 703 Main St
Paterson, NJ 07503
Phone
(973) 754-2000
NPI assigned
Apr 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 25MA11891200 NJ Primary

Addresses

Primary practice location

St. Joseph'S University Medical Hospital 703 Main St
Paterson, NJ 07503

Mailing address

5114 Wyndhurst Dr
Plainsboro, NJ 08536-2035
Phone (609) 815-1172

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
I20231024000520 NJ Practitioner - Family Practice 0547616880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hackensack Meridian Health Medical Group - Primary Care PCGroup PAC ID 7911003330, 364 clinicians

Practice addresses (Care Compare)

4 Hunter St
Suite 203
Lodi, NJ 07644-1608
Phone (551) 996-9100

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
Hackensack Meridian Health Medical Group - Primary Care PC Family Medicine CurrentSince Jul 27, 2023 Accepting new patients
HMH Hospitals Corporation Past Accepting new patients
Meridian Medical Group - Specialty Care, PC Family Medicine Past Accepting new patients

Locations

985 Cedar Bridge Ave
Brick, NJ 08723
Phone (732) 477-5600

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

4 Hunter St
Ste 203
Lodi, NJ 07644
Phone (551) 996-9100

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

300 Perrine Rd
Ste 324
Old Bridge, NJ 08857
Phone (732) 753-9890

650 From Rd
Fl 5
Paramus, NJ 07652
Phone (201) 383-6731

Interoperability endpoints

  • Direct secure messaging: kevin.vasquez@direct.hackensackmeridian.org
  • FHIR API: https://mepic.hmhn.org/fhir/api/FHIR/R4/

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 2

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1669001426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5114 WYNDHURST DR",
            "city": "PLAINSBORO",
            "state": "NJ",
            "postal_code": "085362035",
            "telephone_number": "609-815-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST. JOSEPH'S UNIVERSITY MEDICAL HOSPITAL 703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "07503",
            "telephone_number": "973-754-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "KEVIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA11891200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.