Agile Infusion Medicine PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

AGILE INFUSION MEDICINE PC

Practice address

5 Summit Ave Ste 204
Hackensack, NJ 07601-1271

Phone

(201) 751-2202

Fax

(201) 266-0437

NPI assigned

Sep 27, 2023

Last updated

Dec 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan Wiesen, MDNPI 1912149006

Title

Owner

Phone

(631) 759-9866

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

Enrollment records 2

Locations

Practitioners 2

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.

• Jonathan Wiesen, M.D.

  • Internal Medicine Physician
  • Norfolk, VA
  • NPI 1912149006

  NJ, NY, Pulmonary Disease

  Medicare reassignment NPD Authorized official
• David H. Kupferberg, MD

  • Pulmonary Disease Physician
  • Warren, OH
  • NPI 1548329295

  NJ

  Medicare reassignment NPD

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1972382018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 N FOREST DR",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076662047",
            "telephone_number": "201-751-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SUMMIT AVE STE 204",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011271",
            "telephone_number": "201-751-2202",
            "fax_number": "201-266-0437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "668 N Forest Dr",
            "address_purpose": "LOCATION",
            "city": "Teaneck",
            "state": "NJ",
            "postal_code": "076662047",
            "country_code": "US",
            "telephone_number": "631-759-9866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AGILE INFUSION MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-27",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "WIESEN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-759-9866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aero Ambulance Service, Inc.
• Aesthetic Dental Center of Hackensack LLC
• Kristina Aganova, PSYD
• Jay Agarwal
• Aakash Aggarwal, MD
• Harry Agress Jr., M.D.
• Kimberly C Agresta, LCSW
• Angela Suguey Aguilar, APN
• Michelle Tiffany Rayoso Aguilar, DNP
• Amanda Alyse Ahearn, BA

• Primary Care Clinic/Center in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Primary Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.