NPIMap

Organization Active NPI

Foundation Pediatrics

  • Pediatrics Physician
  • East Orange, NJ
National Provider Identifier
1356387286
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
FOUNDATION PEDIATRICS
Practice address
190 S Harrison St
East Orange, NJ 07018-1502
Phone
(973) 674-8373
NPI assigned
Jun 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Authorized official

Name
Dr. Ronke Dosunmu, MD
Title
Owner
Phone
(973) 674-8373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

190 S Harrison St
East Orange, NJ 07018-1502

Mailing address

190 S Harrison St
East Orange, NJ 07018-1502
Phone (973) 674-8373

Other practice location 1

344 S Harrison St
East Orange, NJ 07018-1235
Phone (973) 674-8373

Other identifiers 1

IdentifierTypeStateIssuer
6011004MedicaidNJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0961768Foundation Pediatrics190 South Harrison Street, East Orange, NJ 07018Certificate of waiverJun 15, 2027

National Provider Directory

National Provider Directory

Locations

190 S Harrison St
East Orange, NJ 07018
Phone (973) 395-1200

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573516800000",
    "number": "1356387286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 S HARRISON ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070181502",
            "telephone_number": "973-674-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 S HARRISON ST",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070181502",
            "telephone_number": "973-674-8373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "344 S Harrison St",
            "address_purpose": "LOCATION",
            "city": "East Orange",
            "state": "NJ",
            "postal_code": "070181235",
            "country_code": "US",
            "telephone_number": "973-674-8373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOUNDATION PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2019-11-12",
        "status": "A",
        "authorized_official_last_name": "DOSUNMU",
        "authorized_official_first_name": "RONKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-674-8373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6011004",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.