Michael Novogroder, M.D.

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

25MA03138700 Issued in NJ

Practice address

704 Palisade Ave
Teaneck, NJ 07666-3144

Phone

(201) 836-4301

Fax

(201) 836-5110

NPI assigned

May 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Tenafly Pediatrics

  • Pediatrics Physician
  • Tenafly, NJ
  • NPI 1750347647
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372982400000",
    "number": "1366496572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 PALISADE AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663144",
            "telephone_number": "201-836-4301",
            "fax_number": "201-530-7337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 PALISADE AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663144",
            "telephone_number": "201-836-4301",
            "fax_number": "201-836-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOGRODER",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2013-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NY",
            "license": "1064061",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NJ",
            "license": "25MA03138700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern New Jersey Surgical Specialists PC
• Northern Star ABA
• Mari Noruzi, DMD
• Steven Michael Novak, M.D.
• Amy Rachel November, LMHC
• David A. Nunez, M.D.
• Nussbaum Medical Group PC
• Sean O'Connor
• Akiko Ogawa, ATC
• Nnenna Ogbonnaya, RN

• Pediatric Endocrinology Physician in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• Pediatric Endocrinology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.