Angela Vidal-Burke, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA09156600 Issued in NJ

Practice address

100 Hollywood Ave
Hillside, NJ 07205-2409

Phone

(908) 353-7949

NPI assigned

Jun 30, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Hillside Family Practice PC

  • Family Medicine Physician
  • Hillside, NJ
  • NPI 1891706842
  NPD (past)
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  NPD (past)
• Montefiore Medical Center

  dba Montefiore Community Pharmacy @ CHAM

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD (past)

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1902068075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOLLYWOOD AVE",
            "city": "HILLSIDE",
            "state": "NJ",
            "postal_code": "072052409",
            "telephone_number": "908-353-7949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOLLYWOOD AVE",
            "city": "HILLSIDE",
            "state": "NJ",
            "postal_code": "072052409",
            "telephone_number": "908-353-7949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDAL-BURKE",
        "first_name": "ANGELA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "246056",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09156600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Parcon Ticzon
• Phyllis Tobin, PH.D.
• Township of Hillside
• Township of Hillside Fire Dept
• Upscale Medical Transportation
• Sandra Vincent
• Walgreen Co (Walgreens #16260)
• Maisha Lo-Rain Walters
• Jessica Charise Webb
• Julita Wilson-Reid, APN

• Family Medicine Physician in Hillside, NJ
• Providers in Hillside, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.