Individual provider Active NPI

Dorothy Stein Bisberg

  • Pediatric Pulmonology Physician
  • West Orange, NJ
National Provider Identifier
1407860406
Registry record updated Feb 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
25MA05228900 Issued in NJ
Practice address
375 Mount Pleasant Ave.
Suite 105
West Orange, NJ 07052
Phone
(973) 322-6900
Fax
(973) 322-6999
NPI assigned
Jul 28, 2006
Last updated
Feb 6, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X 25MA05228900 NJ Primary

Addresses

Primary practice location

375 Mount Pleasant Ave.
Suite 105
West Orange, NJ 07052

Mailing address

271 Forest Rd
South Orange, NJ 07079-1630
Phone (973) 763-3456

Other identifiers 1

IdentifierTypeStateIssuer
2270803MedicaidNJ

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
I20040914000372 NJ Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 7214904853 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05228900NJMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Feb 1, 2013 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Feb 1, 2013 Accepting new patients
Pediatric Specialty Group at the Ambulatory Care Center Pediatric Pulmonology Past Accepting new patients

Locations

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

200 S Orange Ave
Livingston, NJ 07039
Phone (973) 322-7007

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

3 Executive Dr
Ste 400
Somerset, NJ 08873
Phone (732) 369-5949

375 Mount Pleasant Ave
Ste 105
West Orange, NJ 07052
Phone (973) 322-6900

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391644800000",
    "number": "1407860406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 FOREST RD",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791630",
            "telephone_number": "973-763-3456",
            "fax_number": "973-322-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 MOUNT PLEASANT AVE.",
            "address_2": "SUITE 105",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "07052",
            "telephone_number": "973-322-6900",
            "fax_number": "973-322-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISBERG",
        "first_name": "DOROTHY",
        "middle_name": "STEIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2014-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "NJ",
            "license": "25MA05228900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2270803",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.