Individual provider Active NPI

Frederick Okoye Jr., MD

  • Infectious Disease Physician
  • Clifton, NJ
National Provider Identifier
1306815618
Registry record updated Jan 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MA63691 Issued in NJ
Practice address
642 Broad St
Clifton, NJ 07013-1615
Phone
(973) 249-1855
Fax
(973) 249-1856
NPI assigned
Mar 17, 2006
Last updated
Jan 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X MA63691 NJ Primary

Addresses

Primary practice location

642 Broad St
Clifton, NJ 07013-1615

Mailing address

PO Box 428
Stanhope, NJ 07874-0428
Phone (973) 249-1855

Other identifiers 1

IdentifierTypeStateIssuer
7801505MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050127000583 NJ Practitioner - Internal MedicinePractitioner - Infectious Disease 8426008434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

642 Broad St
Suite 1
Clifton, NJ 07013-1647
Phone (973) 249-1855

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA63691NJMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Infectious Diseases Consultants PC Infectious Disease CurrentSince May 1, 2017 Accepting new patients

Locations

98 James St
Ste 208
Edison, NJ 08820
Phone (732) 494-9134

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201132800000",
    "number": "1306815618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "STANHOPE",
            "state": "NJ",
            "postal_code": "078740428",
            "telephone_number": "973-249-1855",
            "fax_number": "973-249-1856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 BROAD ST",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131615",
            "telephone_number": "973-249-1855",
            "fax_number": "973-249-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKOYE",
        "first_name": "FREDERICK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2008-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "MA63691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7801505",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.