Individual provider Active NPI

Charles K. Dadzie, MD

  • Pediatric Pulmonology Physician
  • Neptune, NJ
National Provider Identifier
1104882109
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
MA3895500 Issued in NJ
Practice address
19 Davis Ave FL 5
Neptune, NJ 07753-4488
Phone
(732) 776-4268
Fax
(732) 776-3178
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 25MA03895500 NJ
Pediatric Pulmonology Physician 2080P0214X MA3895500 NJ Primary

Addresses

Primary practice location

19 Davis Ave FL 5
Neptune, NJ 07753-4488

Mailing address

19 Davis Ave FL 5
Neptune, NJ 07753-4488
Phone (732) 776-4268

Other identifiers 1

IdentifierTypeStateIssuer
0452009MedicaidNJ

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
I20041203000057 NJ Practitioner - Critical Care (Intensivists)Practitioner - Pulmonary DiseasePractitioner - Pediatric Medicine 4082679568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.44 of 100Reported as group
Quality
72.96
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA3895500NJMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Complex Care PC CurrentSince Jan 1, 2006 Accepting new patients

Locations

61 Davis Ave
Neptune, NJ 07753
Phone (732) 776-4271

61 Davis Ave
#1
Neptune, NJ 07753
Phone (732) 776-4271

19 Davis Ave
Fl 5
Neptune City, NJ 07753
Phone (732) 776-4860

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

Interoperability endpoints

  • Direct secure messaging: charles.dadzie@direct.hackensackmeridian.org

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1104882109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 DAVIS AVE FL 5",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534488",
            "telephone_number": "732-776-4268",
            "fax_number": "732-776-3178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 DAVIS AVE FL 5",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534488",
            "telephone_number": "732-776-4268",
            "fax_number": "732-776-3178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DADZIE",
        "first_name": "CHARLES",
        "middle_name": "K.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "NJ",
            "license": "25MA03895500",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NJ",
            "license": "MA3895500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0452009",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

Verify at the official NPI Registry.