Unknown Individual – Family Medicine Physician, NPI 1376517516
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
613, Park Avenue, Elm Park Village, East Orange, Essex County, New Jersey, 07017, United States
EAST ORANGE, NJ 070171950
Phone: (973) 672-8573
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $51.
Total Amount is formed as General ($51) + Research ($0) + Ownership ($0) = $51.
Last reported payment date: 2024-03-19 • Largest payer in this snapshot: Dexcom, Inc. ($34).
Total Amount
$51
General + Research + Ownership
Payments
3
Total payment records
General Amount
$51
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dexcom, Inc. | $34 |
| ABBVIE INC. | $17 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 07017)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| FAMILY MEDICINE | NJ | 90670 | Pneumococcal vaccine for injection into muscle | 11 | 11 |
| FAMILY MEDICINE | NJ | 92540 | Observation, testing, and recording of abnormal eye movement | 33 | 33 |
| FAMILY MEDICINE | NJ | 93922 | Ultrasound study of arteries of both arms and legs | 60 | 58 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | NJ | |
| Nurse Practitioner | NJ | |
| Internal Medicine, Geriatric Medicine | NJ | |
| Internal Medicine | NJ | |
| Nurse Practitioner | NJ | |
| Family Practice | NJ | |
| Internal Medicine | NY | |
| Obstetrics/Gynecology, Family Practice | NJ | |
| Nurse Practitioner | NJ | |
| Internal Medicine | NJ |
Reviews
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