Individual provider Active NPI

Clayton Irving Bridges Jr., P.A.-C.

  • Physician Assistant
  • Oakland, NJ
National Provider Identifier
1962625210
Registry record updated Nov 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00146300 Issued in NJ
Practice address
43 Yawpo Ave
Suite 3
Oakland, NJ 07436-2714
Phone
(201) 337-9600
Fax
(201) 337-5101
NPI assigned
Apr 11, 2007
Last updated
Nov 6, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00146300 NJ Primary

Addresses

Primary practice location

43 Yawpo Ave
Suite 3
Oakland, NJ 07436-2714

Mailing address

43 Yawpo Ave
Suite 3
Oakland, NJ 07436-2714
Phone (201) 337-9600

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070608000517 NJ Practitioner - Physician Assistant 6709984032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Physician Services PCGroup PAC ID 3577857333, 593 clinicians

Practice addresses (Care Compare)

108 Jackson St
Apt 6B
Hoboken, NJ 07030-6101
Phone (800) 825-5391

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00146300NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Feb 1, 2010 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Feb 1, 2010 Accepting new patients
Nydic Open MRI of America-Paramus, LLC Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

Interoperability endpoints

  • Direct secure messaging: clayton.bridges.3@5622.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1962625210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 YAWPO AVE",
            "address_2": "SUITE 3",
            "city": "OAKLAND",
            "state": "NJ",
            "postal_code": "074362714",
            "telephone_number": "201-337-9600",
            "fax_number": "201-337-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 YAWPO AVE",
            "address_2": "SUITE 3",
            "city": "OAKLAND",
            "state": "NJ",
            "postal_code": "074362714",
            "telephone_number": "201-337-9600",
            "fax_number": "201-337-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGES",
        "first_name": "CLAYTON",
        "middle_name": "IRVING",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00146300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, NJ

Sources for this page

Verify at the official NPI Registry.