Individual provider Active NPI

Philip Anthony Baddoura

  • Emergency Medicine Physician
  • Paramus, NJ
National Provider Identifier
1093219388
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA11436300 Issued in NJ
Practice address
4 Valley Health PLZ
Paramus, NJ 07652-3619
Phone
(201) 447-8000
NPI assigned
Mar 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA11436300 NJ Primary

Addresses

Primary practice location

4 Valley Health PLZ
Paramus, NJ 07652-3619

Mailing address

4 Valley Health PLZ
Paramus, NJ 07652-3619

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220713001302 NJ Practitioner - Emergency Medicine 9335520089 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11436300NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Emergency Assoc PA Emergency Medicine CurrentSince Jul 1, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1093219388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 VALLEY HEALTH PLZ",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 VALLEY HEALTH PLZ",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523619",
            "telephone_number": "201-447-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADDOURA",
        "first_name": "PHILIP",
        "middle_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA11436300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramus, NJ

Sources for this page

Verify at the official NPI Registry.