Individual provider Active NPI

David John Nitti, MD

  • Internal Medicine Physician
  • Hawthorne, NJ
National Provider Identifier
1750499158
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MA47615 Issued in NJ
Practice address
179 Lafayette Avenue
Hawthorne, NJ 07506-2613
Phone
(973) 427-7243
Fax
(973) 427-9376
NPI assigned
Aug 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MA47615 NJ Primary

Addresses

Primary practice location

179 Lafayette Avenue
Hawthorne, NJ 07506-2613

Mailing address

179 Lafayette Avenue
Hawthorne, NJ 07506-2613
Phone (973) 427-7243

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
I20050928000125 NJ Practitioner - Internal Medicine 5092740100 Reassigns benefits to 2 organizations
Practice locations: Hawthorne, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians

Practice addresses (Care Compare)

108 Jackson St
Apt 6B
Hoboken, NJ 07030-6101
Phone (800) 825-5391

223 N Van Dien Ave
Ridgewood, NJ 07450-2726
Phone (201) 447-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.05 of 100Reported as apm
Quality
85.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA47615NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physician Services PC Internal Medicine CurrentSince Oct 1, 2017 Accepting new patients
Sovereign Medical Group LLC Internal Medicine CurrentSince Jun 1, 2014 Accepting new patients
Sovereign Medical Group, LLC CurrentSince Jun 1, 2014 Accepting new patients

Locations

680 Kinderkamack Rd
Ste 300
Oradell, NJ 07649
Phone (201) 881-7869

223 N Van Dien Ave
Ridgewood, NJ 07450
Phone (201) 447-8417

Interoperability endpoints

  • Direct secure messaging: david.nitti.1@5622.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750499158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 LAFAYETTE AVENUE",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075062613",
            "telephone_number": "973-427-7243",
            "fax_number": "973-427-9376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 LAFAYETTE AVENUE",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075062613",
            "telephone_number": "973-427-7243",
            "fax_number": "973-427-9376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NITTI",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA47615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NJ

Sources for this page

Verify at the official NPI Registry.