Active NPI
Andre D Sotelo, M.D.
- Pulmonary Disease Physician
- Hackensack, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 25MA10770400
- Practice address
- 30 Prospect Ave
Hackensack, NJ 07601-1915 - Phone
- (551) 996-3500
- Fax
- (551) 996-3298
- NPI assigned
- Sep 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 224759 | NY | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 25MA10770400 | NJ | |
| Pulmonary Disease Physician | 207RP1001X | 224759 | NY | |
| Pulmonary Disease Physician | 207RP1001X | 25MA10770400 | NJ | Primary |
Addresses
Primary practice location
30 Prospect Ave
Hackensack, NJ 07601-1915
Mailing address
30 Prospect Ave FL Hall2
Hackensack, NJ 07601-1915
Phone (551) 996-3500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02570607 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Critical Care (Intensivists)
- Education
- Rutgers New Jersey Medical School, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (551) 996-5045
Hospital & facility affiliations
- Hackensack University Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.33 of 100
- Quality
- 66.38
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.39
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current | Accepting new patients | |
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Hackensack Meridian Health Medical Group - Specialty Care PC | Current | Accepting new patients | |
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| Icahn School of Medicine at Mount Sinai | Critical Care Medicine | Current | Accepting new patients |
| Icahn School of Medicine at Mount Sinai | Current | Accepting new patients | |
| St Lukes Roosevelt Community Care | Past | Accepting new patients |
Locations
30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066
30 Prospect Ave
Fl HALL2
Hackensack, NJ 07601
3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463
200 Old Country Rd
Mineola, NY 11501
Phone (516) 408-4900
1090 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2211
425 W 59th St
Ste 9C
New York, NY 10019
Phone (212) 492-5550
36 W 60th St
New York, NY 10023
Phone (212) 265-2828
150 E 42nd St
Fl 9
New York, NY 10017
Phone (646) 605-8119
1000 10th Ave
New York, NY 10019
Phone (212) 523-2369
10 Union Sq E
New York, NY 10003
Phone (212) 253-6800
Interoperability endpoints
- andre.sotelo@direct.hackensackmeridian.org
- https://fhir4.healow.com/fhir/r4/IHJHBD
Organizations & group practices 9
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.
-
- Surgical Critical Care Physician
- Red Bank, NJ
- NPI 1215989249
-
- Surgery Physician
- New York, NY
- NPI 1104295716
-
- Pediatrics Physician
- New York, NY
- NPI 1275802811
-
- Durable Medical Equipment & Medical Supplies
- North Bergen, NJ
- NPI 1215734199
-
- Internal Medicine Physician
- New York, NY
- NPI 1063881787
-
- Pulmonary Disease Physician
- New York, NY
- NPI 1518228550
Critical Care Medicine
-
- Internal Medicine Physician
- New York, NY
- NPI 1568868834
-
- Eyewear Supplier
- New York, NY
- NPI 1760227466
-
- Internal Medicine Physician
- New York, NY
- NPI 1740469246
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hackensack, NJ
- NPI 1457456279
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583884800000",
"number": "1982698577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 PROSPECT AVE FL HALL2",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076011915",
"telephone_number": "551-996-3500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 PROSPECT AVE",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076011915",
"telephone_number": "551-996-3500",
"fax_number": "551-996-3298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOTELO",
"first_name": "ANDRE",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-09",
"last_updated": "2020-03-11",
"certification_date": "2020-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "NY",
"license": "224759",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "NJ",
"license": "25MA10770400",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NY",
"license": "224759",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NJ",
"license": "25MA10770400",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02570607",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.