Individual provider Active NPI

Pablo Vazquez, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • North Bergen, NJ
National Provider Identifier
1811280175
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
25MA09932500 Issued in NJ
Practice address
8901 Kennedy Blvd
North Bergen, NJ 07047-5344
Phone
(201) 430-2022
NPI assigned
May 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 25MA09932500 NJ Primary

Addresses

Primary practice location

8901 Kennedy Blvd
North Bergen, NJ 07047-5344

Mailing address

1450 Washington St Apt 1206
Hoboken, NJ 07030-9403
Phone (973) 615-5036

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
I20171003006826 NJ Practitioner - Physical Medicine and Rehabilitation 5991018947 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA09932500NJMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physiatrists of New Jersey CurrentSince Jul 29, 2017 Accepting new patients
Synergy Orthopedics & Spine Current Accepting new patients
Quick Med Medical LLC Current Accepting new patients
Humc Opco LLC Current Accepting new patients
Advanced Rehabilitation and Pain Medicine Group, Inc. Past Accepting new patients
Advanced Rehabilitation and Pain Medicine Past Accepting new patients

Locations

1040 State Route 36
Atlantic Hlds, NJ 07716
Phone (732) 291-0740

66 W Gilbert St
Ste 100
Tinton Falls, NJ 07701
Phone (201) 795-8637

300 Old Hook Rd
Westwood, NJ 07675
Phone (201) 566-2675

Interoperability endpoints

  • Direct secure messaging: pablo.vazquez@direct.hobokenumc.md

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": "1305763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1811280175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 WASHINGTON ST APT 1206",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070309403",
            "telephone_number": "973-615-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 KENNEDY BLVD",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475344",
            "telephone_number": "201-430-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "PABLO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-19",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NJ",
            "license": "25MA09932500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bergen, NJ

Sources for this page

Verify at the official NPI Registry.