Organization Active NPI

Vascular and Endovascular Associates of NJ LLC

  • Vascular Surgery Physician
  • Ridgewood, NJ
National Provider Identifier
1689808974
Registry record updated Feb 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
25MA06880800 Issued in NJ
Legal business name
VASCULAR AND ENDOVASCULAR ASSOCIATES OF NJ LLC
Practice address
89 N Maple Ave
Ridgewood, NJ 07450-3235
Phone
(201) 389-3700
Fax
(201) 670-6725
NPI assigned
May 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2013

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

Authorized official

Name
Dr. Tarek A Alshafie, MDNPI 1336182641
Title
General Surgeon/Vascular Surgeon
Phone
(201) 389-3700

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
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X 25MA06880800 NJ Primary

Addresses

Primary practice location

89 N Maple Ave
Ridgewood, NJ 07450-3235

Mailing address

89 N Maple Ave
Ridgewood, NJ 07450-3235
Phone (201) 389-3700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090623000094 NJ Part B Supplier - Clinic/Group Practice 7214088871 Receives reassigned benefits from 2 practitioners
Practice locations: Paramus, NJ

National Provider Directory

National Provider Directory

Locations

1 W Ridgewood Ave
Ste 106
Paramus, NJ 07652
Phone (201) 389-3700

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360800000000",
    "number": "1689808974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 N MAPLE AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503235",
            "telephone_number": "201-389-3700",
            "fax_number": "201-670-6725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 N MAPLE AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503235",
            "telephone_number": "201-389-3700",
            "fax_number": "201-670-6725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR AND ENDOVASCULAR ASSOCIATES OF NJ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-14",
        "last_updated": "2013-02-14",
        "status": "A",
        "authorized_official_last_name": "ALSHAFIE",
        "authorized_official_first_name": "TAREK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "GENERAL SURGEON/VASCULAR SURGEON",
        "authorized_official_telephone_number": "201-389-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MA06880800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.