Alfin G Vicencio, MD

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

License

25MA12296500 Issued in NJ

Practice address

30 Prospect Ave
Wfan 3Rd Floor
Hackensack, NJ 07601-1915

Phone

(551) 996-5207

NPI assigned

Oct 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: avicencio15897@nychhc.direct-ci.com
• FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249

  Pediatrics

  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1821174772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD",
            "address_2": "BLDG 2, STE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "address_2": "WFAN 3RD FLOOR",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-5207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 E 98th St",
            "address_2": "10th floor",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296501",
            "country_code": "US",
            "telephone_number": "212-241-7788",
            "fax_number": "212-876-3255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VICENCIO",
        "first_name": "ALFIN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "212630",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NY",
            "license": "212630",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NJ",
            "license": "25MA12296500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ivelise Velez, LCSW
• Robert A Vena, L.AC., MSTOM
• Laura Venanzi, RDN
• Karen A Venezia, LCSW
• David H Vesole, MD
• Lance Aaron Vicente, DMD
• Vida Wellness and Counseling Services LLC
• Vidas En Alto LLC
• Patrick Sewell Vidaver, MD
• Maureen Viehmeyer

• Pediatric Pulmonology Physician in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Pediatric Pulmonology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.