Individual provider Active NPI

Philip Ofosu Eck, M.D.

  • Anesthesiology Physician
  • Hackensack, NJ
National Provider Identifier
1003251349
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA10212800 Issued in NJ
Practice address
30 Prospect Ave Ste 2703
Hackensack, NJ 07601-1915
Phone
(551) 996-2419
Fax
(551) 996-3962
NPI assigned
Apr 30, 2013
Last updated
Apr 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 301946 NY
Anesthesiology Physician 207L00000X 25MA10212800 NJ Primary

Addresses

Primary practice location

30 Prospect Ave Ste 2703
Hackensack, NJ 07601-1915

Mailing address

30 Prospect Ave Ste 2703
Hackensack, NJ 07601-1915
Phone (551) 996-2419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY, MA3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180201000640 NJ Practitioner - Anesthesiology 7214297720 Reassigns benefits to 2 organizations
I20200325002447 NY Practitioner - Anesthesiology 7214297720 Reassigns benefits to 1 organization
I20211217001605 MA Practitioner - Anesthesiology 7214297720 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
301946NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Healthcare Specialists PC Anesthesiology CurrentSince Jan 16, 2018 Accepting new patients
Pain Management Institute PA Anesthesiology CurrentSince Jun 1, 2022 Accepting new patients
JJM Medical Services, PC Anesthesiology CurrentSince Mar 11, 2020 Accepting new patients

Locations

1440 Main St
Waltham, MA 02451
Phone (781) 891-9300

171 Interstate Dr
Ste 101
West Springfield, MA 01089
Phone (413) 737-5500

619 River Dr
Elmwood Park, NJ 07407
Phone (201) 703-2900

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

30 Prospect Ave
Ste 2703
Hackensack, NJ 07601
Phone (551) 996-2419

5 Johnson Rd
Latham, NY 12110
Phone (518) 767-0869

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1003251349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE STE 2703",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-2419",
            "fax_number": "551-996-3962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE STE 2703",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011915",
            "telephone_number": "551-996-2419",
            "fax_number": "551-996-3962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECK",
        "first_name": "PHILIP",
        "middle_name": "OFOSU",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-30",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "301946",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA10212800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.