NPIMap

Individual provider Active NPI

Jackson A Okoya, MD

  • Pulmonary Disease Physician
  • Irvington, NJ
National Provider Identifier
1174615165
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MA52181 Issued in NJ
Practice address
40 Union Ave
Suite 204
Irvington, NJ 07111-3277
Phone
(973) 416-6981
Fax
(973) 375-5766
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MA52181 NJ Primary

Addresses

Primary practice location

40 Union Ave
Suite 204
Irvington, NJ 07111-3277

Mailing address

1 Astor PL
Avenel, NJ 07001-1460
Phone (973) 416-6981

Other identifiers 1

IdentifierTypeStateIssuer
3822109MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040105000061 NJ Practitioner - Internal Medicine 9931008414 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Physicians Associates PAGroup PAC ID 5698784155, 4 clinicians
State of New Jersey Omb Centralized PayrollGroup PAC ID 6406742592, 129 clinicians

Practice addresses (Care Compare)

40 Union Ave
Suite 204
Irvington, NJ 07111-3290
Phone (973) 416-6981

59 Koch Ave
Morris Plains, NJ 07950-4400
Phone (973) 538-1800

Hospital & facility affiliations

  • Barnabas Health Home Care and Hospice Home health agency, West Orange, NJ, CCN 317061
  • Newark Beth Israel Medical Center Hospital, Newark, NJ, CCN 310002
  • Cooperman Barnabas Medical Center Hospital, Livingston, NJ, CCN 310076
  • Carewell Health Medical Center Hospital, East Orange, NJ, CCN 310083
  • Axia Care Center of Orange Nursing home, Orange, NJ, CCN 315352
  • Alliance Care Rehabilitation and Nursing Center Nursing home, Irvington, NJ, CCN 315359
  • Complete Care at Orange Park Nursing home, East Orange, NJ, CCN 315178
  • South Mountain HC Nursing home, Vauxhall, NJ, CCN 315283
  • White House Healthcare and Rehabilitation Center Nursing home, Orange, NJ, CCN 315372

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA52181NJMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newark Beth Israel Medical Center Inc Past Accepting new patients
Seacrest Medical Associates, P.a. Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Columbus Hospital Ltach LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jokoya261051@epicdirect.rwjbh.org

Organizations & group practices 6

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 8

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174615165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ASTOR PL",
            "city": "AVENEL",
            "state": "NJ",
            "postal_code": "070011460",
            "telephone_number": "973-416-6981",
            "fax_number": "973-375-5766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 UNION AVE",
            "address_2": "SUITE 204",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113277",
            "telephone_number": "973-416-6981",
            "fax_number": "973-375-5766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKOYA",
        "first_name": "JACKSON",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "MA52181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3822109",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvington, NJ

Sources for this page

Verify at the official NPI Registry.