Individual provider Active NPI

Eveline C Traeger, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Mountainside, NJ
National Provider Identifier
1326016304
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
25MA06061600 Issued in NJ
Practice address
150 New Providence Rd
Mountainside, NJ 07092-2590
Phone
(908) 301-5491
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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 25MA06061600 NJ Primary

Addresses

Primary practice location

150 New Providence Rd
Mountainside, NJ 07092-2590

Mailing address

150 New Providence Rd
Mountainside, NJ 07092-2590
Phone (908) 301-5491

Other identifiers 1

IdentifierTypeStateIssuer
6183603MedicaidNJ

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
I20081110000020 NJ Practitioner - Pediatric Medicine 6608935416 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA06061600NJMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Specialized Hospital CurrentSince Jun 30, 2010 Accepting new patients
Children' Specialized Hospital CurrentSince Jun 30, 2010 Accepting new patients

Locations

150 New Providence Rd
Mountainside, NJ 07092

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226620800000",
    "number": "1326016304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 NEW PROVIDENCE RD",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922590",
            "telephone_number": "908-301-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 NEW PROVIDENCE RD",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922590",
            "telephone_number": "908-301-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAEGER",
        "first_name": "EVELINE",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NJ",
            "license": "25MA06061600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6183603",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountainside, NJ

Sources for this page

Verify at the official NPI Registry.