NPIMap

Organization Active NPI

Bergen County Improvement Authority

Doing business as Bergen New Bridge Medical Center Medical Provider Group

  • Internal Medicine Physician
  • Paramus, NJ
National Provider Identifier
1891836441
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BERGEN COUNTY IMPROVEMENT AUTHORITY
Doing business as
Bergen New Bridge Medical Center Medical Provider Group
Practice address
230 E Ridgewood Ave
Paramus, NJ 07652-4142
Phone
(201) 967-4000
NPI assigned
Feb 8, 2007
Last updated
Dec 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Authorized official

Name
Mauro Raguseo
Title
Executive Director of Bcia
Phone
(201) 335-6350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

230 E Ridgewood Ave
Paramus, NJ 07652-4142

Mailing address

230 E Ridgewood Ave BLDG 10
Paramus, NJ 07652-4142
Phone (201) 967-4001

Other names 1

  • Bergen New Bridge Medical Center Medical Provider Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040419001038 NJ Part B Supplier - Clinic/Group Practice 9032104047 Receives reassigned benefits from 134 practitioners
Practice locations: Paramus, NJ

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bergen New Bridge Medical CenterParamus, NJ, CCN 310058 Hospital Operational/Managerial Control Oct 1, 2017
Bergen New Bridge Medical CenterParamus, NJ, CCN 31S058 Hospital Operational/Managerial Control Oct 1, 2017
Bergen New Bridge Medicial CenterParamus, NJ, CCN 315017 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2017
Dec 27, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 147

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 147

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576540800000",
    "number": "1891836441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 E RIDGEWOOD AVE BLDG 10",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076524142",
            "telephone_number": "201-967-4001",
            "fax_number": "201-225-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 E RIDGEWOOD AVE",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076524142",
            "telephone_number": "201-967-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN COUNTY IMPROVEMENT AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A",
        "authorized_official_last_name": "RAGUSEO",
        "authorized_official_first_name": "MAURO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF BCIA",
        "authorized_official_telephone_number": "201-335-6350"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bergen New Bridge Medical Center Medical Provider Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paramus, NJ

Sources for this page

Verify at the official NPI Registry.