Individual provider Active NPI

Altagracia Trinidad, M.D.

  • Pediatrics Physician
  • New Brunswick, NJ
National Provider Identifier
1407870611
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MA50530 Issued in NJ
Practice address
254 Easton Ave
New Brunswick, NJ 08901-1766
Phone
(732) 745-8600
Fax
(732) 249-9572
NPI assigned
Jul 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MA50530 NJ Primary

Addresses

Primary practice location

254 Easton Ave
New Brunswick, NJ 08901-1766

Mailing address

254 Easton Ave
New Brunswick, NJ 08901-1766

Other identifiers 1

IdentifierTypeStateIssuer
0751103MedicaidNJ

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
I20041118000895 NJ Practitioner - Pediatric Medicine 9032173026 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA50530NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Garden State Healthcare Associates, LLC CurrentSince Nov 21, 2016 Accepting new patients
Hudson Hospital Opco LLC Current Accepting new patients
Newark Beth Israel Medical Center Inc Past Accepting new patients
Jersey City Medical Center Past Accepting new patients
Nbimc Family Health Center Pediatrics Past Accepting new patients

Locations

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

10 Exchange Pl
Fl 15
Jersey City, NJ 07302
Phone (201) 821-8900

176 Palisade Ave
Jersey City, NJ 07306
Phone (201) 795-8200

80 Johnson Ave
Newark, NJ 07108
Phone (973) 623-8592

Interoperability endpoints

  • Direct secure messaging: altagracia.trinidad@direct.christhospital.md

Organizations & group practices 5

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407870611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 EASTON AVE",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 EASTON AVE",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011766",
            "telephone_number": "732-745-8600",
            "fax_number": "732-249-9572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRINIDAD",
        "first_name": "ALTAGRACIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA50530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0751103",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.