Benjamin Chouake, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA04032000 Issued in NJ

Practice address

663 Palisade Avenue
Suite 101
Cliffside Park, NJ 07010

Phone

(201) 917-2246

Fax

(201) 917-2276

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Internal Medicine

Education

State University of New York at Stony Brook, School of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cliffside Medical LLCGroup PAC ID 0042230740, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008
• Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Cliffside Medical LLC

  • Dermatology Physician
  • Cliffside Park, NJ
  • NPI 1104908813

  Internal Medicine

  Medicare reassignment Care Compare group NPD Authorized official
• Emergimed LLC

  dba Cliffside Surgery Center

  • Surgery Physician
  • Cliffside Park, NJ
  • NPI 1003196981
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Englewood Hospital and Medical Center

  • General Acute Care Hospital
  • Englewood, NJ
  • NPI 1083612881
  Care Compare affiliation
• Holy Name Hospital Regional Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Teaneck, NJ
  • NPI 1043389349

  Hospital

  Care Compare affiliation
• Holy Name Medical Center Inc.

  • General Acute Care Hospital
  • Teaneck, NJ
  • NPI 1104859131
  Care Compare affiliation

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404086400000",
    "number": "1891804654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1546",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076320546",
            "telephone_number": "201-917-2246",
            "fax_number": "201-917-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 PALISADE AVENUE",
            "address_2": "SUITE 101",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "07010",
            "telephone_number": "201-917-2246",
            "fax_number": "201-917-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOUAKE",
        "first_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2014-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA04032000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0923605",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE NY",
            "identifier": "27A041",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US HEALTHCARE",
            "identifier": "505147",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bella Chimidova, COTA
• Anna Cho, DACM
• Eugene Hongsuk Choi
• Olivia Rose Choi
• Sun Choi, DACM
• Jason Chouake, M.D.
• Chris Vecchione PT LLC (Emerge Physical Therapy & Wellness)
• Constantine G Christolias, DDS DOCTOR OF DENTIS
• Thomas Chun, MD
• Steven S Chung, L.AC

• Internal Medicine Physician in Cliffside Park, NJ
• Providers in Cliffside Park, 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 Jun 30, 2014; 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.
• 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.