Individual provider Active NPI

Peter Heilbroner, MD

  • Neurology Physician
  • Ridgewood, NJ
National Provider Identifier
1861453011
Registry record updated Apr 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MA66993 Issued in NJ
Practice address
1200 East Ridgewood Ave
East Wing - 2ND Floor
Ridgewood, NJ 07450
Phone
(201) 444-0868
Fax
(201) 493-0797
NPI assigned
Mar 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MA66993 NJ Primary

Addresses

Primary practice location

1200 East Ridgewood Ave
East Wing - 2ND Floor
Ridgewood, NJ 07450

Mailing address

1200 East Ridgewood Ave
East Wing - 2ND Floor
Ridgewood, NJ 07450
Phone (201) 444-0868

Other identifiers 1

IdentifierTypeStateIssuer
7707100MedicaidNJ

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
I20100913000039 NJ Practitioner - Neurology 6204868052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurology Group of Bergen County PAGroup PAC ID 5698755056, 26 clinicians

Practice addresses (Care Compare)

1200 E Ridgewood Ave
Ridgewood, NJ 07450-3957
Phone (201) 444-0868

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
MA66993NJMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Institute for Pain, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: peter.heilbroner.1@25202.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1861453011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 EAST RIDGEWOOD AVE",
            "address_2": "EAST WING - 2ND FLOOR",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "07450",
            "telephone_number": "201-444-0868",
            "fax_number": "201-493-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 EAST RIDGEWOOD AVE",
            "address_2": "EAST WING - 2ND FLOOR",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "07450",
            "telephone_number": "201-444-0868",
            "fax_number": "201-493-0797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEILBRONER",
        "first_name": "PETER",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "MA66993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7707100",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.