Jose R Fragoso, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

25MA04358900 Issued in NJ

Practice address

4808 Bergenline Ave
5TH Floor
Union City, NJ 07087-5172

Phone

(201) 865-3444

Fax

(201) 865-0038

NPI assigned

Feb 20, 2006

Last updated

Feb 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dr. Jose R Fragoso Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Jose Fragoso MD

  • Pediatrics Physician
  • Union City, NJ
  • NPI 1346452166
  Authorized official Same address or phone
• Ivy Pediatrics, PA

  • Pediatrics Physician
  • Manalapan, NJ
  • NPI 1871660407
  NPD (past)

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1164497624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4808 BERGENLINE AVE",
            "address_2": "5TH FLOOR",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070875172",
            "telephone_number": "201-865-3444",
            "fax_number": "201-865-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4808 BERGENLINE AVE",
            "address_2": "5TH FLOOR",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070875172",
            "telephone_number": "201-865-3444",
            "fax_number": "201-865-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAGOSO",
        "first_name": "JOSE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NJ",
            "license": "25MA04358900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "81801",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "HP080",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1140004",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSE",
            "last_name": "FRAGOSO",
            "middle_name": "R",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Flexible Motion Physical Therapy PC
• Ana Maria Flores
• Luz E Fontanez, MA
• Anthony R Forestine, M.D.
• Four Corners Community Services LLC
• Francisco D Gonzalez MD PA
• Goelis Francisco, BCJ
• Freedom of Choice Heathcare, Inc
• Freedom of Choice Heathcare, Inc
• Fresenius Medical Care Union City Home, LLC (Hudson Home Therapies)

• Pediatric Adolescent Medicine Physician in Union City, NJ
• Providers in Union City, NJ by specialty
• Pediatric Adolescent Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.