Metropolitan Surgical Associates Inc. Dba Metropolitan Medical Assoc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

10263 A Issued in NJ

Legal business name

METROPOLITAN SURGICAL ASSOCIATES INC. DBA METROPOLITAN MEDICAL ASSOC

Practice address

40 Engle St
Englewood, NJ 07631-2905

Phone

(201) 567-0522

Fax

(201) 567-5955

NPI assigned

Mar 12, 2007

Last updated

Mar 5, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Isabelle Tarikyan

Title

Cfo

Phone

(201) 567-0522

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679605729. Details of each certification follow.

• CCN 31C0001006 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 31C0001006

Legal name

METROPOLITAN SURGICAL ASSOCIATES

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Oct 29, 1985

Last certification

Oct 29, 2021

Ownership / control type

Proprietary

Facility address

40 Engle Street
Englewood, NJ 07631

Locations

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.

• Constantine George Binas, M.D.

  • Obstetrics & Gynecology Physician
  • Englewood, NJ
  • NPI 1427066257
  NPD
• Keith Gresham, M.D.

  • Obstetrics & Gynecology Physician
  • Englewood, NJ
  • NPI 1063599215
  NPD (past)
• Vladimir Kilinsky, M.D.

  • Obstetrics & Gynecology Physician
  • Englewood, NJ
  • NPI 1942218623
  NPD (past)
• Bruce Tisch, MD

  • Obstetrics & Gynecology Physician
  • Englewood, NJ
  • NPI 1932117629
  NPD (past)

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393977600000",
    "number": "1679605729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312905",
            "telephone_number": "201-567-0522",
            "fax_number": "201-567-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 ENGLE ST",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312905",
            "telephone_number": "201-567-0522",
            "fax_number": "201-567-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPOLITAN SURGICAL ASSOCIATES INC. DBA METROPOLITAN MEDICAL ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2014-03-05",
        "status": "A",
        "authorized_official_last_name": "TARIKYAN",
        "authorized_official_first_name": "ISABELLE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "201-567-0522",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NJ",
            "license": "10263 A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2979802",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary Mason Merriam, D.O.
• Janice Messick, RD, CDE
• Wade Metro, MD
• Metropolitan Anesthesia Group LLC
• Metropolitan Neurosurgery Associates, PC
• Victoria Meyerov, NP
• Michael D Vardy Gynecology and Urogynecology, LLC
• Oren Michaeli, D.O
• Julita Michalowska
• Kathryn M Michelotti, DNP APRN FNP-BC CCRN

• Ambulatory Surgical Clinic/Center in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Ambulatory Surgical Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.