Individual provider Active NPI

Hakkyung Lee Kovacs, NPC

  • Adult Health Nurse Practitioner
  • Woodland Park, NJ
National Provider Identifier
1720390180
Registry record updated Jul 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NN99280 Issued in NJ
Practice address
1031 McBride Ave
Suite C204
Woodland Park, NJ 07424-2559
Phone
(973) 785-0060
NPI assigned
Jul 13, 2010
Last updated
Jul 13, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NN99280 NJ Primary
Critical Care Medicine Registered Nurse 163WC0200X 99280 NJ

Addresses

Primary practice location

1031 McBride Ave
Suite C204
Woodland Park, NJ 07424-2559

Mailing address

736 Westwood Ave
Rivervale, NJ 07675-6641
Phone (201) 952-9529

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140904001390 NJ Practitioner - Nurse Practitioner 1759509714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

25 Rockwood PL
Suite 110
Englewood, NJ 07631-4959
Phone (201) 894-5805

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.09 of 100Reported as apm
Quality
86.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
99280NJMDCritical Care Medicine Registered Nurse
NN99280NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Englewood, PC CurrentSince Feb 1, 2018 Accepting new patients
Physician Partners of Englewood, PC PastSince Jan 1, 2025 Accepting new patients
Pain Management and Wellness of Palisades Past Accepting new patients
Spinecare Orthopedics, PC Past Accepting new patients
Trustees of Columbia University in the City of New York Past Accepting new patients

Locations

180 Engle St
Englewood, NJ 07631
Phone (201) 567-2050

25 Rockwood Pl
Ste 110
Englewood, NJ 07631
Phone (201) 894-5805

309 Engle St
Ste 7
Englewood, NJ 07631
Phone (201) 487-7246

350 Engle St
Englewood, NJ 07631
Phone (201) 871-6073

22-02 Broadway
Ste 301
Fair Lawn, NJ 07410
Phone (201) 414-5016

24 Elm St
Ste 203
Harrington Pk, NJ 07640
Phone (201) 784-0123

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

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": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278979200000",
    "number": "1720390180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 WESTWOOD AVE",
            "city": "RIVERVALE",
            "state": "NJ",
            "postal_code": "076756641",
            "telephone_number": "201-952-9529",
            "fax_number": "201-497-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 MCBRIDE AVE",
            "address_2": "SUITE C204",
            "city": "WOODLAND PARK",
            "state": "NJ",
            "postal_code": "074242559",
            "telephone_number": "973-785-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACS",
        "first_name": "HAKKYUNG",
        "middle_name": "LEE",
        "credential": "NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-13",
        "last_updated": "2010-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "NN99280",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NJ",
            "license": "99280",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Park, NJ

Sources for this page

Verify at the official NPI Registry.