EVERGREEN MEDICAL GROUP PC
NPI 1295516409
Physical Medicine & Rehabilitation in River Edge, NJ

Active since October 12, 2023CLIA 31D2321162 · Waiver
887 KINDERKAMACK RD STE 2, RIVER EDGE, NJ 07661(201) 464-0860(888) 440-2752 Get Directions Write a Review

NPPES record last updated: February 11, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 11, 2025, Feb 3, 2025, Oct 12, 2023 (3 updates tracked since 2023).

About Evergreen Medical Group Pc NPPES

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

EVERGREEN MEDICAL GROUP PC (NPI 1295516409) is a healthcare organization registered as a physical medicine & rehabilitation in River Edge, New Jersey and active in the NPI registry since October 2023. The organization holds a CLIA Waiver certificate valid through March 30, 2027, maintains a secondary practice location in Fair Lawn, and lists Grigory Shtender, Owner, as its authorized official.

NPPES Registry Identity

NPI1295516409
Entity TypeOrganization
Primary Taxonomy208100000X
Legal Business NameEVERGREEN MEDICAL GROUP PC
Location Address887 KINDERKAMACK RD STE 2River Edge, NJ 07661-2307
Mailing Address887 Kinderkamack Rd Ste 2River Edge, NJ 07661-2307 · (201) 464-0860
Fax(888) 440-2752
Organization SubpartNo
Authorized OfficialGrigory ShtenderOwner · (201) 791-7771
Enumeration DateOctober 12, 2023
Last NPPES UpdateFebruary 11, 20253 updates tracked since enumeration
NPPES CertifiedFebruary 11, 2025
✔ NPI 1295516409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 10

★ Primary SpecialtyPhysical Medicine & RehabilitationAllopathic & Osteopathic Physicians
Taxonomy Code208100000X
Definition
Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices.
Also ListedChiropractorTaxonomy 111N00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedSurgery · Vascular SurgeryTaxonomy 2086S0129X
Also ListedPodiatrist · Foot & Ankle SurgeryTaxonomy 213ES0103X
Also ListedPhysical TherapistTaxonomy 225100000X
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X
887 KINDERKAMACK RD STE 2, River Edge, NJ 07661

Secondary Practice Location 1

Location 131-00 BroadwayFair Lawn, NJ 07410-3963 · Phone (201) 791-7771 · Fax (201) 350-8614

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
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

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Evergreen Medical Group Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

16

Medicare enrollment records show 16 clinicians reassign Medicare billing to Evergreen Medical Group PC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 7 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 9

Nurse Practitioner7
Chiropractic2
Family Practice1
Internal Medicine1
Physical Medicine and Rehabilitation1
Physical Therapist in Private Practice1
Podiatry1
Psychiatry1
1 other specialty1

Clinicians, nearest first (16)

Nurse Practitioner
NPI 1891126173
887 KINDERKAMACK RD STE 2
River Edge, NJ 07661
(201) 464-0860
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1649798455
887 KINDERKAMACK RD
River Edge, NJ 07661
(201) 464-0860
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1205767829
887 KINDERKAMACK RD STE 2
River Edge, NJ 07661
(201) 464-0860
✔ PECOS✔ Accepts MedicareSame address
Internal Medicine
NPI 1023270253
887 KINDERKAMACK RD STE 2
River Edge, NJ 07661
(201) 464-0860
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1508608746
887 KINDERKAMACK RD
River Edge, NJ 07661
(201) 646-0860
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1659199065
151 W PASSAIC ST
Rochelle Park, NJ 07662
(908) 516-0787
✔ PECOS✔ Accepts Medicare3.1 mi
Nurse Practitioner
NPI 1326898206
7 VIVIAN AVE
Emerson, NJ 07630
(845) 664-3411
✔ PECOS✔ Accepts Medicare3.1 mi
Nurse Practitioner
NPI 1346628567
714 10TH ST
Secaucus, NJ 07094
(201) 368-1717
✔ PECOS✔ Accepts Medicare10 mi
Chiropractic
NPI 1609548932
6000 JFK BLVD
West New York, NJ 07093
(201) 758-0099
✔ Accepts Medicare10 mi
Physical Therapist in Private Practice
NPI 1649569773
278 FOREST ST
Belleville, NJ 07109
(973) 580-9136
✔ Accepts Medicare11 mi
Chiropractic
NPI 1760569594
340 RAMAPO VALLEY RD
Oakland, NJ 07436
(201) 651-9100
13 mi
Podiatry
NPI 1962798413
25 W 45TH ST SUITE 402
New York, NY 10036
(212) 704-4310
✔ PECOS✔ Accepts Medicare13 mi
Vascular Surgery
NPI 1184888968
506 6TH ST
Brooklyn, NY 11215
(718) 780-3288
✔ PECOS✔ Accepts Medicare19 mi
Family Practice
NPI 1861051575
99 BEAUVOIR AVE
Summit, NJ 07901
(862) 415-0509
✔ PECOS✔ Accepts Medicare23 mi
Physical Medicine and Rehabilitation
NPI 1952316614
2995 OCEAN PKWY
Brooklyn, NY 11235
(718) 934-2211
✔ PECOS✔ Accepts Medicare25 mi
Psychiatry
NPI 1538233721
650 RANCOCAS RD
Westampton, NJ 08060
(609) 267-7000
✔ PECOS✔ Accepts Medicare77 mi

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D2321162

Evergreen Medical Group · River Edge, NJ
Active · expires Mar 30, 2027
CLIA Number31D2321162
Laboratory TypePhysician Office
Certificate Effective DateMarch 31, 2025
Certificate Expiration DateMarch 30, 2027
Laboratory DirectorVasyl Pidkaminetskiy
Laboratory Phone(201) 464-0860
Laboratory LocationEvergreen Medical Group887 Kinderkamack Road, River Edge, NJ 07661
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Evergreen Medical Group PC's NPI number?

The NPI number for Evergreen Medical Group PC is 1295516409. It was assigned to this organization in the NPPES registry on October 12, 2023.

Where is Evergreen Medical Group PC located?

Evergreen Medical Group PC is located at 887 Kinderkamack Rd Ste 2, River Edge, NJ 07661. The listed phone number is (201) 464-0860.

What is Evergreen Medical Group PC's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation with taxonomy code 208100000X.

Is Evergreen Medical Group PC enrolled in Medicare?

Yes. Evergreen Medical Group PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Evergreen Medical Group PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 16 clinicians in 9 Medicare specialties reassign their Medicare billing to Evergreen Medical Group PC. 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 Nurse Practitioner (7), Chiropractic (2) and Family Practice (1). Of these, 5 practice at this address and 7 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Evergreen Medical Group PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2321162) is associated with this NPI, valid through March 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Evergreen Medical Group PC accept?

Health plans from Oscar Health list Evergreen Medical Group PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Evergreen Medical Group PC was last updated on February 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.