Individual provider Active NPI

Sylvia Baszak, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • New Brunswick, NJ
National Provider Identifier
1407958606
Registry record updated May 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
25MA08104900 Issued in NJ
Practice address
1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928
Phone
(732) 235-7044
Fax
(732) 235-6006
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 25MA08104900 NJ Primary

Addresses

Primary practice location

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928

Mailing address

66 W Gilbert St
2ND FL.
Tinton Falls, NJ 07701-4947
Phone (732) 212-0051

Other identifiers 1

IdentifierTypeStateIssuer
0112348MedicaidNJ

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
I20071012000018 NJ Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 6103912704 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08104900NJMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare , LLC CurrentSince Jan 13, 2020 Accepting new patients
Advocare, LLC CurrentSince Jan 13, 2020 Accepting new patients
Pediatric Associates of NJ PC Past Accepting new patients

Locations

169 Mine Brook Rd
#P
Bernardsville, NJ 07924
Phone (908) 766-0034

300B Princeton Hightstown Rd
Ste 201
East Windsor, NJ 08520
Phone (609) 448-7300

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275004800000",
    "number": "1407958606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 W GILBERT ST",
            "address_2": "2ND FL.",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014947",
            "telephone_number": "732-212-0051",
            "fax_number": "732-212-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROBERT WOOD JOHNSON PL",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928",
            "telephone_number": "732-235-7044",
            "fax_number": "732-235-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASZAK",
        "first_name": "SYLVIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2010-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NJ",
            "license": "25MA08104900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0112348",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.