EVERGREEN PHYSICIANS OF NORTH JERSEY, PC – NPI #1912956152
Internal Medicine

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

EVERGREEN PHYSICIANS OF NORTH JERSEY, PC is a provider located in ROCHELLE PARK, NJ. NPPES has assigned the NPI number 1912956152 to EVERGREEN PHYSICIANS OF NORTH JERSEY, PC on May 06, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207R00000X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine.

The NPI profile was previously updated about 5 years ago on Dec 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EVERGREEN PHYSICIANS OF NORTH JERSEY, PC below.

NPI Profile for
EVERGREEN PHYSICIANS OF NORTH JERSEY, PC

NPI Number
1912956152
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EVERGREEN PHYSICIANS OF NORTH JERSEY, PC
Primary location
96 PARKWAY
EVERGREEN PHYSICIANS OF NORTH JERSEY, PC
ROCHELLE PARK, NJ 07662-4200
Phone: (973) 450-2540 Fax: (919) 425-0478
Mailing address
3114 CROASDAILE DR STE 200
EVERGREEN PHYSICIANS OF NORTH JERSEY, PC
DURHAM, NC 27705-2508
Phone: (954) 838-2371 Fax:
Organization Subpart
No
Authorized Official
KATHY KONDAS
OFFICER
Phone: (973) 251-1132
Updated
Certification Date
Dec 22, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for EVERGREEN PHYSICIANS OF NORTH JERSEY, PC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDNJ0102091
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207R00000X
- Internal Medicine (Primary)
NJ 25MB06960500

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.