Individual provider Active NPI

Ankita Vaidya, MD

  • Internal Medicine Physician
  • Passaic, NJ
National Provider Identifier
1699391268
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA11994000 Issued in NJ
Practice address
350 Boulevard
Passaic, NJ 07055-2840
Phone
(973) 365-4300
NPI assigned
Jun 19, 2020
Last updated
Dec 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA11994000 NJ Primary

Addresses

Primary practice location

350 Boulevard
Passaic, NJ 07055-2840

Mailing address

17 Lackawanna PL Apt 212
Bloomfield, NJ 07003-2956
Phone (347) 821-0802

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240105002520 NJ Practitioner - Hospitalist 3971954793 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine of Morris County LLCGroup PAC ID 2466428388, 77 clinicians

Practice addresses (Care Compare)

16 Pocono Rd
Denville, NJ 07834-2901
Phone (973) 784-6868

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine of Morris County LLC Internal Medicine CurrentSince Apr 19, 2025 Accepting new patients
Ihpnj ER LLC Past Accepting new patients
Prime Healthcare Services - Saint Clare's LLC Past Accepting new patients
Prime Healthcare Services - St. Mary's Passaic LLC Past Accepting new patients

Locations

16 Pocono Rd
Denville, NJ 07834
Phone (973) 625-5651

25 Pocono Rd
Denville, NJ 07834
Phone (273) 625-6000

400 W Blackwell St
Dover, NJ 07801
Phone (973) 537-3818

350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1699391268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LACKAWANNA PL APT 212",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070032956",
            "telephone_number": "347-821-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BOULEVARD",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070552840",
            "telephone_number": "973-365-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAIDYA",
        "first_name": "ANKITA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-19",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA11994000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

Verify at the official NPI Registry.