Individual provider Active NPI

Teresita C Redondo, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Livingston, NJ
National Provider Identifier
1013098714
Registry record updated Jan 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
25MA03608200 Issued in NJ
Practice address
94 Old Short Hills Rd
Livingston, NJ 07039-5672
Phone
(973) 322-5763
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Immunopathology Physician 207ZI0100X 25MA03608200 NJ
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 25MA03608200 NJ Primary

Addresses

Primary practice location

94 Old Short Hills Rd
Livingston, NJ 07039-5672

Mailing address

PO Box 66689
Falmouth, ME 04105-6689
Phone (866) 689-8862

Other identifiers 1

IdentifierTypeStateIssuer
1753801MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.85 of 100Reported as group
Quality
68.07
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03608200NJMDImmunopathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263254400000",
    "number": "1013098714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66689",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041056689",
            "telephone_number": "866-689-8862",
            "fax_number": "207-347-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 OLD SHORT HILLS RD",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395672",
            "telephone_number": "973-322-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDONDO",
        "first_name": "TERESITA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2010-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZI0100X",
            "taxonomy_group": "",
            "desc": "Pathology, Immunopathology",
            "state": "NJ",
            "license": "25MA03608200",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA03608200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1753801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.