Organization Active NPI

Integrated Healthcare Group, P.C.

  • Internal Medicine Physician
  • West New York, NJ
National Provider Identifier
1669577318
Registry record updated Feb 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INTEGRATED HEALTHCARE GROUP, P.C.
Practice address
5600 Kennedy Blvd W
West New York, NJ 07093-1256
Phone
(201) 866-3100
Fax
(201) 866-0321
NPI assigned
Sep 14, 2006
Last updated
Feb 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2025

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

Authorized official

Name
Ellen Vitievsky, M.D.NPI 1366547135
Title
Owner
Phone
(201) 866-3100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

5600 Kennedy Blvd W
West New York, NJ 07093-1256

Mailing address

PO Box 7664
North Brunswick, NJ 08902-7664
Phone (201) 866-3100

Other identifiers 1

IdentifierTypeStateIssuer
0076911MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050722000185 NJ Part B Supplier - Clinic/Group Practice 8123054855 Receives reassigned benefits from 2 practitioners
Practice locations: West New York, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2102236Integrated Healthcare Group, PC5600 Kennedy Blvd, West New York, NJ 07093Certificate of waiverSep 2, 2027

National Provider Directory

National Provider Directory

Locations

5600 Kennedy Blvd E
West New York, NJ 07093

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739664000000",
    "number": "1669577318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7664",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089027664",
            "telephone_number": "201-866-3100",
            "fax_number": "201-866-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 KENNEDY BLVD W",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070931256",
            "telephone_number": "201-866-3100",
            "fax_number": "201-866-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED HEALTHCARE GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2025-02-16",
        "certification_date": "2025-02-16",
        "status": "A",
        "authorized_official_last_name": "VITIEVSKY",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-866-3100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0076911",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West New York, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.