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BERGEN SURGICAL SPECIALISTS, PA
NPI 1003963158
Specialist in Hackensack, NJ

Active since January 04, 2007
211 ESSEX ST, SUITE 102, HACKENSACK, NJ 07601(201) 487-8882(201) 487-0943 Get Directions Write a Review

NPPES record last updated: April 16, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Bergen Surgical Specialists, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BERGEN SURGICAL SPECIALISTS, PA (NPI 1003963158) is a healthcare organization registered as a specialist in Hackensack, New Jersey and active in the NPI registry since January 2007. The organization lists Gregory T. Simonian, President, as its authorized official.

NPPES Registry Identity

NPI1003963158
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameBERGEN SURGICAL SPECIALISTS, PA
Location Address211 ESSEX ST, SUITE 102Hackensack, NJ 07601-3231
Mailing Address211 Essex Street, Suite 102Hackensack, NJ 07601 · (201) 487-8882 · Fax (201) 487-0943
Phone(201) 487-8882
Fax(201) 487-0943
Organization SubpartNo
Authorized OfficialGregory T. SimonianPresident · (201) 446-8202
Enumeration DateJanuary 4, 2007
Last NPPES UpdateApril 16, 2024
✔ NPI 1003963158 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NJ · MA59895
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
211 ESSEX ST, Hackensack, NJ 07601
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Other Identifiers 1

Medicaid6209009NJ

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bergen Surgical Specialists, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

8

Medicare enrollment records show 8 clinicians reassign Medicare billing to Bergen Surgical Specialists, PA, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 7 within 10 miles. They are listed nearest first.

Clinicians, nearest first (8)

Anjali Ratnathicam, DO
Vascular Surgery
NPI 1922257252
211 ESSEX ST SUITE 102
Hackensack, NJ 07601
(201) 487-8882
✔ PECOS✔ Accepts MedicareSame address
Gregory Simonian, MD
General Surgery
NPI 1528017944
211 ESSEX ST STE 102
Hackensack, NJ 07601
(201) 487-8882
✔ PECOS✔ Accepts MedicareSame address
Michael Wilderman, MD
Vascular Surgery
NPI 1497802938
211 ESSEX ST SUITE 102
Hackensack, NJ 07601
(201) 487-8882
✔ PECOS✔ Accepts MedicareSame address
Kenneth Walsh, MD
Vascular Surgery
NPI 1225458144
211 ESSEX STREET SUITE 102
Hackensack, NJ 07601
(201) 487-8882
✔ PECOS✔ Accepts MedicareSame address
Jinny Lu, M.D.
Vascular Surgery
NPI 1306231279
211 ESSEX ST STE 102
Hackensack, NJ 07601
(732) 447-4234
✔ PECOS✔ Accepts MedicareSame address
Kristin Cook, MD
Vascular Surgery
NPI 1093976466
211 ESSEX ST STE 102
Hackensack, NJ 07601
(201) 487-2144
✔ PECOS✔ Accepts MedicareSame address
James Geuder, MD
Vascular Surgery
NPI 1619022068
20 PROSPECT AVE SUITE 707
Hackensack, NJ 07601
(201) 488-2220
✔ PECOS✔ Accepts Medicare0.3 mi
David O'connor, M.D.
Vascular Surgery
NPI 1063736510
303 GEORGE ST STE 105
New Brunswick, NJ 08901
(732) 993-5500
✔ PECOS✔ Accepts Medicare34 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bergen Surgical Specialists, PA's NPI number?

The NPI number for Bergen Surgical Specialists, PA is 1003963158. It was assigned to this organization in the NPPES registry on January 4, 2007.

Where is Bergen Surgical Specialists, PA located?

Bergen Surgical Specialists, PA is located at 211 Essex St Suite 102, Hackensack, NJ 07601. The listed phone number is (201) 487-8882.

What is Bergen Surgical Specialists, PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Bergen Surgical Specialists, PA enrolled in Medicare?

Yes. Bergen Surgical Specialists, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bergen Surgical Specialists, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 2 Medicare specialties reassign their Medicare billing to Bergen Surgical Specialists, PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Vascular Surgery (7) and General Surgery (1). Of these, 6 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Bergen Surgical Specialists, PA was last updated on April 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.