Phillip I Ayeni, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA06177800 Issued in NJ

Practice address

30 Prospect Ave
Pediatrics
Hackensack, NJ 07601-1914

Phone

(201) 996-2000

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Interoperability endpoints

• Direct secure messaging: phillip.ayeni@direct.hackensackmeridian.org
• FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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

• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249

  Pediatrics

  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233100800000",
    "number": "1023050366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070111421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PROSPECT AVE",
            "address_2": "PEDIATRICS",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011914",
            "telephone_number": "201-996-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYENI",
        "first_name": "PHILLIP",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2009-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06177800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avenir Ventures LLC
• Matthew Avenoso
• Laura Kathryn Avery, FNP-C
• Ari Jason Avram, M.D.
• Maged George Ayad, D.D.S., PH.D.
• Zainab Ayoub
• Suzanne Ayoubi, MD
• Mina N Ayyad, MD
• Farjana Azad, AGACNP-BC
• Marvin Basilio Azares, APN

• Pediatrics Physician in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.