Organization Active NPI

Joyful Healthcare LLC

  • Pediatrics Physician
  • Fair Lawn, NJ
National Provider Identifier
1104589118
Registry record updated May 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
JOYFUL HEALTHCARE LLC
Practice address
12-15 Broadway Ste 2a
Fair Lawn, NJ 07410-2031
Phone
(201) 266-5365
Fax
(478) 202-9392
NPI assigned
Oct 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2022

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

Authorized official

Name
Dr. Isabel Odeida Velez, MDNPI 1992194906
Title
Member
Phone
(201) 936-9660

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

12-15 Broadway Ste 2a
Fair Lawn, NJ 07410-2031

Mailing address

29 Sanders PL
Butler, NJ 07405-1211
Phone (201) 936-9660

Other identifiers 1

IdentifierTypeStateIssuer
0825115MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211110000033 NJ Part B Supplier - Clinic/Group Practice 4688063803 Receives reassigned benefits from 1 practitioner
Practice locations: Fair Lawn, NJ

National Provider Directory

National Provider Directory

Locations

12-15 Broadway
Ste 2A
Fair Lawn, NJ 07410
Phone (201) 334-2537

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1634342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651363200000",
    "number": "1104589118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 SANDERS PL",
            "city": "BUTLER",
            "state": "NJ",
            "postal_code": "074051211",
            "telephone_number": "201-936-9660",
            "fax_number": "478-202-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12-15 BROADWAY STE 2A",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102031",
            "telephone_number": "201-266-5365",
            "fax_number": "478-202-9392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOYFUL HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-16",
        "last_updated": "2022-05-01",
        "certification_date": "2022-05-01",
        "status": "A",
        "authorized_official_last_name": "VELEZ",
        "authorized_official_first_name": "ISABEL",
        "authorized_official_middle_name": "ODEIDA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "201-936-9660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0825115",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.