Eileen Kodack, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

25MB11443700 Issued in NJ

Practice address

125 Paterson St # 3100
New Brunswick, NJ 08901-1962

Phone

(732) 235-6631

NPI assigned

Mar 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Anesthesiology

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rutgers Health-RWJ Pediatric Critical CareGroup PAC ID 1355390287, 153 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Robert Wood Johnson University Hospital Hospital, New Brunswick, NJ, CCN 310038

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Rutgers Health-RWJ Pediatric Critical Care

  • Family Medicine Physician
  • New Brunswick, NJ
  • NPI 1780766527
  Medicare reassignment Care Compare group NPD
• Rutgers Health-RWJ Pediatric Critical Care

  • Anesthesiology Physician
  • New Brunswick, NJ
  • NPI 1861414989
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Robert Wood Johnson University Hospital, Inc

  • General Acute Care Hospital
  • New Brunswick, NJ
  • NPI 1346243375
  Care Compare affiliation

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1326543737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST # 3100",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST # 3100",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962",
            "telephone_number": "732-235-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KODACK",
        "first_name": "EILEEN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-27",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MB11443700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helene Knee, LCSW
• Samuel Jason Knee
• Beth E Knox, MSN,RN,NPC ,AOCN
• Julia Knypinski, M.D.
• Kevin Ko, M.D.
• Kristina Leigh Kokinda, DNP, CPNP AC/PC
• Jerzy Kolaczynski
• Sudha R Kolli, MD
• Gayathri Kollipara, DO
• Liliana Kolvites, ACNPC-AG

• Anesthesiology Physician in New Brunswick, NJ
• Providers in New Brunswick, NJ by specialty
• Anesthesiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.