Individual provider Active NPI

Tokunbo T Dada, MD

  • Pediatrics Physician
  • Irvington, NJ
National Provider Identifier
1144324559
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA04826700 Issued in NJ
Practice address
50 Union Avenue
Sutie 702
Irvington, NJ 07111
Phone
(973) 373-7110
Fax
(973) 373-0076
NPI assigned
Sep 8, 2006
Last updated
Apr 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA04826700 NJ Primary

Addresses

Primary practice location

50 Union Avenue
Sutie 702
Irvington, NJ 07111

Mailing address

50 Union Avenue
Sutie 702
Irvington, NJ 07111
Phone (973) 373-7110

Other identifiers 1

IdentifierTypeStateIssuer
343730201MedicaidNJ

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

LicenseStateTypeSpecialty
25MA04826700NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newark Beth Israel Medical Center Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tokunbo.dada.1@16632.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1144324559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 UNION AVENUE",
            "address_2": "SUTIE 702",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "07111",
            "telephone_number": "973-373-7110",
            "fax_number": "973-373-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 UNION AVENUE",
            "address_2": "SUTIE 702",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "07111",
            "telephone_number": "973-373-7110",
            "fax_number": "973-373-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DADA",
        "first_name": "TOKUNBO",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-08",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA04826700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "343730201",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.