C. Dicovsky Medical Group, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

059094 Issued in NJ

Legal business name

C. DICOVSKY MEDICAL GROUP, LLC

Practice address

681 Broadway
Paterson, NJ 07514-1421

Phone

(973) 278-1000

Fax

(973) 278-1709

NPI assigned

Jul 20, 2005

Organization subpart

No

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

Authorized official

Name

Teresa Lares

Title

Manager

Phone

(973) 278-1000

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marcela C. Marani-Dicovskiy, M.D.

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1386727287
  Medicare reassignment Care Compare group NPD
• Safwan A Sweidan, MD

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1578644860
  Medicare reassignment Care Compare group NPD
• Mary Ragnone, BSNRN

  • Registered Nurse
  • Paterson, NJ
  • NPI 1780018499
  NPD (past)

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646870400000",
    "number": "1821097940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 BROADWAY",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075141421",
            "telephone_number": "973-278-1000",
            "fax_number": "973-278-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 BROADWAY",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075141421",
            "telephone_number": "973-278-1000",
            "fax_number": "973-278-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C. DICOVSKY MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A",
        "authorized_official_last_name": "LARES",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "973-278-1000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "059094",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "064703",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": "NJ",
            "license": "024361",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrian David Buritica, RN
• John Paul Bustamante, MD
• Cagla Buyukkoc, MD
• Nathaniel John Byrnes
• C-Line Community Outreach Services Inc.
• Edwin Cabassa, MSN,APRN,BC
• June Cade, DOCTORATE DEGREE
• Jindang Cai, DDS
• Bryan Calero, MD
• Kirsten Calica, MD

• Internal Medicine Physician in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.