Individual provider Active NPI

Alexandra J D'Agostini, MD

  • Pediatric Orthopaedic Surgery Physician
  • Cedar Knolls, NJ
National Provider Identifier
1104288232
Registry record updated Sep 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X
License
25MA11623200 Issued in NJ
Practice address
218 Ridgedale Ave Ste 101
Cedar Knolls, NJ 07927-2109
Phone
(973) 538-7700
Fax
(973) 538-9478
NPI assigned
Mar 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 89282 GA
Orthopaedic Surgery Physician 207X00000X 25MA11623200 NJ
Pediatric Orthopaedic Surgery Physician 207XP3100X 25MA11623200 NJ Primary

Addresses

Primary practice location

218 Ridgedale Ave Ste 101
Cedar Knolls, NJ 07927-2109

Mailing address

402 Lippincott Dr
Marlton, NJ 08053-4112
Phone (856) 782-3300

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
I20221007000101 NJ Practitioner - Orthopedic Surgery 9537456223 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89282GAMDOrthopaedic Surgery Physician
25MA11623200NJMDPediatric Orthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Consensus Medical Group LLC Orthopaedic Surgery CurrentSince Oct 1, 2022 Accepting new patients
Children'S Orthopaedics of Atlanta P.C. Orthopaedic Surgery PastSince Feb 1, 2022 Accepting new patients
CMG Medical Group I LLC Past Accepting new patients

Locations

218 Ridgedale Ave
Ste 101
Cedar Knolls, NJ 07927
Phone (973) 285-1700

706 Bergen Ave
Ste 2
Jersey City, NJ 07306
Phone (201) 464-8888

402 Lippincott Dr
Marlton, NJ 08053
Phone (410) 763-8787

404 Lippincott Dr
Marlton, NJ 08053

609 Morris Ave
Fl 2
Springfield, NJ 07081
Phone (732) 532-3668

Interoperability endpoints

  • Direct secure messaging: adagostini17891@uihealth.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1104288232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 LIPPINCOTT DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534112",
            "telephone_number": "856-782-3300",
            "fax_number": "856-504-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 RIDGEDALE AVE STE 101",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079272109",
            "telephone_number": "973-538-7700",
            "fax_number": "973-538-9478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AGOSTINI",
        "first_name": "ALEXANDRA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-28",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "89282",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": "25MA11623200",
            "primary": false
        },
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "NJ",
            "license": "25MA11623200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Knolls, NJ

Sources for this page

Verify at the official NPI Registry.