Joseph Rozdeba, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

25MA03882300 Issued in NJ

Practice address

42 Locust Ave
Wallington, NJ 07057-1300

Phone

(973) 777-0340

Fax

(973) 777-9424

NPI assigned

May 26, 2006

Last updated

Jun 28, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• New Jersey Urology LLC

  • Urology Physician
  • Bloomfield, NJ
  • NPI 1588822423
  Medicare reassignment NPD
• Primecare Pediatrics, P.C

  • Pediatric Adolescent Medicine Physician
  • Wallington, NJ
  • NPI 1619074820
  NPD
• Urology Consultants PA

  • Urology Physician
  • Belleville, NJ
  • NPI 1609982099
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1003862368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 LOCUST AVE",
            "city": "WALLINGTON",
            "state": "NJ",
            "postal_code": "070571300",
            "telephone_number": "973-777-0340",
            "fax_number": "973-777-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 LOCUST AVE",
            "city": "WALLINGTON",
            "state": "NJ",
            "postal_code": "070571300",
            "telephone_number": "973-777-0340",
            "fax_number": "973-777-9424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZDEBA",
        "first_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MA03882300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1091905",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrozdeba10061@njurology.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "New Jersey Urology LLC",
            "address_1": "1515 Broad St",
            "address_2": "Suite B130",
            "city": "Bloomfield",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070033002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Primecare Pediatrics, P.C
• Tadeusz Pyz, M.D.
• Sofia Roca, LMT
• Beata Rodzen, PA
• Christopha Honorata Rozdeba, MD
• Joanna Sawicka
• Perla Maitee Sieruta
• Martha S Sliwowski, M.D.
• Stanislaw Sliwowski, M.D.
• Vanessa Solano

• Urology Physician in Wallington, NJ
• Providers in Wallington, NJ by specialty
• Urology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.