Organization Active NPI

Northlands Orthopaedic Institute, LLC

  • Orthopaedic Surgery Physician
  • Wayne, NJ
National Provider Identifier
1194218008
Registry record updated Jun 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
NORTHLANDS ORTHOPAEDIC INSTITUTE, LLC
Practice address
504 Valley Rd Ste 200
Wayne, NJ 07470
Phone
(973) 317-1182
NPI assigned
Jun 14, 2018
Last updated
Jun 14, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2018

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

Authorized official

Name
Kinga Dybas
Title
Cfo/Practice Administrator
Phone
(973) 317-1182

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

504 Valley Rd Ste 200
Wayne, NJ 07470

Mailing address

504 Valley Rd Ste 200
Wayne, NJ 07470-3534
Phone (973) 317-1182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190327000550 NJ Part B Supplier - Clinic/Group Practice 2163762287 Receives reassigned benefits from 1 practitioner
Practice locations: Wayne, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528934400000",
    "number": "1194218008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 VALLEY RD STE 200",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703534",
            "telephone_number": "973-317-1182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 VALLEY RD STE 200",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "07470",
            "telephone_number": "973-317-1182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLANDS ORTHOPAEDIC INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-14",
        "last_updated": "2018-06-14",
        "status": "A",
        "authorized_official_last_name": "DYBAS",
        "authorized_official_first_name": "KINGA",
        "authorized_official_title_or_position": "CFO/PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "973-317-1182"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.