NPIMap

Individual provider Active NPI

Richard D Oliver, M.D.

  • Internal Medicine Physician
  • Fair Lawn, NJ
National Provider Identifier
1811081763
Registry record updated Jan 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA03505200 Issued in NJ
Practice address
22-18 Broadway
Suite 104
Fair Lawn, NJ 07410-1552
Phone
(201) 797-4503
Fax
(201) 797-4270
NPI assigned
Oct 3, 2006
Last updated
Jan 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2018

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 25MA03505200 NJ Primary

Addresses

Primary practice location

22-18 Broadway
Suite 104
Fair Lawn, NJ 07410-1552

Mailing address

22-18 Broadway
Suite 104
Fair Lawn, NJ 07410-1552
Phone (201) 797-4503

Other identifiers 1

IdentifierTypeStateIssuer
2843102MedicaidNJ

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
I20050104000072 NJ Practitioner - Internal MedicinePractitioner - Geriatric Medicine 5597713883 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Rutgers New Jersey Medical School, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Englewood PCGroup PAC ID 1355512252, 538 clinicians

Practice addresses (Care Compare)

22 -02 Broadway
Fair Lawn, NJ 07410-3016

24 Elm St
Harrington Park, NJ 07640-1902
Phone (201) 451-1601

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Health Care Center CurrentSince Jun 14, 1989 Accepting new patients
Christian Health Care Center CurrentSince Jun 14, 1989 Accepting new patients
Medical Associates of Englewood, PC Internal Medicine CurrentSince Jul 30, 2016 Accepting new patients
St Josephs University Medical Center Inc. Past Accepting new patients

Locations

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

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

22-18 Broadway
Ste 104
Fair Lawn, NJ 07410
Phone (201) 797-4503

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

150 Warren St
Jersey City, NJ 07302
Phone (201) 309-3000

301 Sicomac Ave
Wyckoff, NJ 07481
Phone (201) 848-5200

Interoperability endpoints

  • Direct secure messaging: richard.oliver@direct.carepointhealth.org
  • Direct secure messaging: roliver236699@direct.englewoodhealth.org

Organizations & group practices 4

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 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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515110400000",
    "number": "1811081763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22-18 BROADWAY",
            "address_2": "SUITE 104",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074101552",
            "telephone_number": "201-797-4503",
            "fax_number": "201-797-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22-18 BROADWAY",
            "address_2": "SUITE 104",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074101552",
            "telephone_number": "201-797-4503",
            "fax_number": "201-797-4270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "RICHARD",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2018-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA03505200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2843102",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

Verify at the official NPI Registry.