Active NPI
Justina Anyanwu, MD
- Pediatrics Physician
- Irvington, NJ
National Provider Identifier
1124034806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MA060169
- Practice address
- 1182 Stuyvesant Ave
Irvington, NJ 07111-1057 - Phone
- (973) 399-0571
- Fax
- (973) 399-1555
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MA060169 | NJ | Primary |
Addresses
Primary practice location
1182 Stuyvesant Ave
Irvington, NJ 07111-1057
Mailing address
1182 Stuyvesant Ave
Irvington, NJ 07111-1057
Phone (973) 399-0571
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7191308 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA060169 | NJ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Newark Beth Israel Medical Center Inc | Past | Accepting new patients | |
| Sunnyside Pediatrics LLC | Past | Accepting new patients | |
| Newark Community Health Centers, Inc. | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/TGXWVOelATtk6ci_q_H9utj9QjU3VuOR/
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Medical Specialty Clinic/Center
- Irvington, NJ
- NPI 1114291721
-
dba Newark Beth Israel Medical Center
- General Acute Care Hospital
- Newark, NJ
- NPI 1215027966
-
- Federally Qualified Health Center (FQHC)
- Newark, NJ
- NPI 1740345693
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124034806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1182 STUYVESANT AVE",
"city": "IRVINGTON",
"state": "NJ",
"postal_code": "071111057",
"telephone_number": "973-399-0571",
"fax_number": "973-399-1555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1182 STUYVESANT AVE",
"city": "IRVINGTON",
"state": "NJ",
"postal_code": "071111057",
"telephone_number": "973-399-0571",
"fax_number": "973-399-1555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANYANWU",
"first_name": "JUSTINA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "MA060169",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7191308",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Irvington, NJ
- Answers Moving Forward Supportive Services
- Answers Moving Forward Supportive Services LLC
- Anukwuem Enterprises, Inc (LCT Medical)
- Anukwuem Enterprises, Inc (LCT Medical)
- Chidi Iheanacho Anukwuem, M.D.
- Adaeze Uzoamaka Anyora
- Anthony Apigo, MD
- Appropriate Place Inc
- Appropriate Place Inc
- Mark Steven Arak, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.