Organization Active NPI

Robin Ellen Leder, M.D., L.L.C.

  • General Practice Physician
  • Hackensack, NJ
National Provider Identifier
1114063872
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ROBIN ELLEN LEDER, M.D., L.L.C.
Practice address
235 Prospect Ave
Suite LB
Hackensack, NJ 07601-2510
Phone
(201) 525-1155
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robin Ellen Leder, M.D.NPI 1750437950
Title
Owner
Phone
(201) 525-1155

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
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

235 Prospect Ave
Suite LB
Hackensack, NJ 07601-2510

Mailing address

235 Prospect Ave
Suite LB
Hackensack, NJ 07601-2510
Phone (201) 525-1155

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070705000157 NJ Part B Supplier - Clinic/Group Practice 4587764592 Receives reassigned benefits from 1 practitioner
Practice locations: Hackensack, NJ

National Provider Directory

National Provider Directory

Locations

235 Prospect Ave
Ste Lb
Hackensack, NJ 07601
Phone (201) 525-1155

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": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114063872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 PROSPECT AVE",
            "address_2": "SUITE LB",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012510",
            "telephone_number": "201-525-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 PROSPECT AVE",
            "address_2": "SUITE LB",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012510",
            "telephone_number": "201-525-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBIN ELLEN LEDER, M.D., L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEDER",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-525-1155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.