EVERGREEN MEDICAL GROUP PC
NPI 1295516409
Physical Medicine & Rehabilitation in River Edge, NJ
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
Specialties & Licenses 10
Secondary Practice Location 1
Group Practice 2
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, NJOther Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
RIVER EDGE, NJ 07661
RIVER EDGE, NJ 07661
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.
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.
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 18 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.