Individual provider Active NPI

Janet Elgallab, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Minneapolis, MN
National Provider Identifier
1154607489
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
62896 Issued in MN
Practice address
2828 Chicago Ave Ste 200
Minneapolis, MN 55407-1544
Phone
(612) 879-1000
Fax
(612) 879-9116
NPI assigned
Nov 1, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 62896 MN Primary

Addresses

Primary practice location

2828 Chicago Ave Ste 200
Minneapolis, MN 55407-1544

Mailing address

2828 Chicago Ave Ste 200
Minneapolis, MN 55407-1544
Phone (612) 879-1000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jelgallab13302@direct-uhnj.org Direct University Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160909000691 NY Practitioner - Neurology 8224324710 Reassigns benefits to 1 organization
I20200409000470 NJ Practitioner - Neurology 8224324710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Rutgers New Jersey Medical School, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Physician Associates of New Jersey IncGroup PAC ID 9830003417, 374 clinicians

Practice addresses (Care Compare)

90 Bergen St
Suite 8100
Newark, NJ 07103-2425
Phone (973) 982-2550

Hospital & facility affiliations

  • The University Hospital Hospital, Newark, NJ, CCN 310119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62896MNMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Sep 15, 2016 Accepting new patients
New York University CurrentSince Sep 15, 2016 Accepting new patients
University Physician Associates of New Jersey Inc Neurology With Special Qualifications in Child Neurology CurrentSince Mar 10, 2020 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Mar 10, 2020 Accepting new patients
University Physician Associates of New Jersey Inc Past Accepting new patients
Quest Diagnostics LLC Il PastSince Oct 9, 2017 Accepting new patients
University Hospital Past Accepting new patients

Locations

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

90 Bergen St
#8100
Newark, NJ 07103
Phone (973) 972-2323

90 Bergen St
#4300
Newark, NJ 07103
Phone (973) 972-2100

30 Bergen St
#12
Newark, NJ 07107
Phone (973) 972-0037

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645747200000",
    "number": "1154607489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 CHICAGO AVE STE 200",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071544",
            "telephone_number": "612-879-1000",
            "fax_number": "612-879-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 CHICAGO AVE STE 200",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071544",
            "telephone_number": "612-879-1000",
            "fax_number": "612-879-9116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELGALLAB",
        "first_name": "JANET",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-01",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MN",
            "license": "62896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jelgallab13302@direct-uhnj.org",
            "affiliation": "Y",
            "endpointDescription": "Epic",
            "affiliationName": "University Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "150 Bergen St",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071032496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.