Individual provider Active NPI

Ivy J Sacknowitz, M.D.

  • Anesthesiology Physician
  • Totowa, NJ
National Provider Identifier
1710980867
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MAA05313500 Issued in NJ
Practice address
525 Union Blvd
Totowa, NJ 07512-2442
Phone
(973) 928-5360
NPI assigned
May 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA 53135 NJ
Anesthesiology Physician 207L00000X 25MAA05313500 NJ Primary

Addresses

Primary practice location

525 Union Blvd
Totowa, NJ 07512-2442

Mailing address

PO Box 343
Midland Park, NJ 07432-0343
Phone (201) 804-2800

Other identifiers 1

IdentifierTypeStateIssuer
0716707MedicaidNJ

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040806001060 NJ Practitioner - Anesthesiology 3779578513 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Associates of New Jersey LLCGroup PAC ID 4284706656, 78 clinicians

Practice addresses (Care Compare)

925 Clifton Ave
Suite 100
Clifton, NJ 07013-2724
Phone (973) 458-0408

Merit-based Incentive Payment System (MIPS)

Final score
92.42 of 100Reported as group
Quality
91.18
Improvement activities
40
Cost
77.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA 53135NJMDSpecialist
25MAA05313500NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County Wide Anesthesia Group, LLC Specialist Current Accepting new patients

Locations

680 Broadway
Paterson, NJ 07514
Phone (973) 977-6600

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1710980867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 343",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074320343",
            "telephone_number": "201-804-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 UNION BLVD",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075122442",
            "telephone_number": "973-928-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKNOWITZ",
        "first_name": "IVY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA 53135",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MAA05313500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0716707",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Totowa, NJ

Sources for this page

Verify at the official NPI Registry.