NPIMap

Individual provider Active NPI

Nicholas T Pecorelli, M.D.

  • Internal Medicine Physician
  • Wood-Ridge, NJ
National Provider Identifier
1699744755
Registry record updated Dec 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA06462500 Issued in NJ
Practice address
245 Valley Blvd
Wood-Ridge, NJ 07075-1236
Phone
(201) 438-5500
Fax
(201) 438-3363
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2012

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 25MA06462500 NJ Primary

Addresses

Primary practice location

245 Valley Blvd
Wood-Ridge, NJ 07075-1236

Mailing address

245 Valley Blvd
Wood-Ridge, NJ 07075-1236
Phone (201) 438-5500

Other identifiers 6

IdentifierTypeStateIssuer
P867458OtherNJOXFORD
5151665OtherNJAETNA PPO
7088407MedicaidNJ
8097769OtherNJCIGNA HMO
1K5877OtherNJHEALTHNET
110207170OtherNJRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100923000302 NJ Practitioner - Internal Medicine 4587700281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers New Jersey Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

277 Hackensack St
Wood Ridge, NJ 07075-1206
Phone (201) 438-5500

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Hackensack, NJ, CCN 317047
  • Visiting Health Services of New Jersey Home health agency, Woodland Park, NJ, CCN 317058
  • Valley Home Care Inc. Home health agency, Paramus, NJ, CCN 317008
  • Adoration Home Health Home health agency, Clifton, NJ, CCN 317017
  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
  • Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008
  • Kessler Rehab Center Inpatient rehabilitation facility, West Orange, NJ, CCN 313025

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06462500NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nicholas T Pecorelli M D L L C Internal Medicine CurrentSince Jul 1, 1997 Accepting new patients
Maria V Pantano DO CurrentSince Oct 30, 2022 Accepting new patients
Valley West Medical Internal Medicine PastSince Sep 14, 2009 Accepting new patients

Locations

245 Valley Blvd
Wood Ridge, NJ 07075
Phone (201) 438-5500

277 Hackensack St
Wood Ridge, NJ 07075
Phone (201) 438-5500

Interoperability endpoints

  • Direct secure messaging: pecorelli.nicholas.008.0300143@dnp.meditab.direct-ci.com

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 10

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354579200000",
    "number": "1699744755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 VALLEY BLVD",
            "city": "WOOD-RIDGE",
            "state": "NJ",
            "postal_code": "070751236",
            "telephone_number": "201-438-5500",
            "fax_number": "201-438-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 VALLEY BLVD",
            "city": "WOOD-RIDGE",
            "state": "NJ",
            "postal_code": "070751236",
            "telephone_number": "201-438-5500",
            "fax_number": "201-438-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECORELLI",
        "first_name": "NICHOLAS",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2012-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06462500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P867458",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5151665",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7088407",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HMO",
            "identifier": "8097769",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "1K5877",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110207170",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wood-Ridge, NJ

Sources for this page

Verify at the official NPI Registry.