Shideh Doroudi, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA09499400 Issued in NJ

Practice address

1020 Main St Ste C
Paterson, NJ 07503-2244

Phone

(862) 336-1200

Fax

(862) 236-1202

NPI assigned

Oct 20, 2014

Last updated

Oct 20, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

Specialty

Family Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Josephs Medical Group PCGroup PAC ID 8628470325, 217 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph's University Medical Center Inc Hospital, Paterson, NJ, CCN 310019

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St Josephs Medical Group PC

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1205425519
  Medicare reassignment Care Compare group NPD
• Browne Medical, LLC

  • Urgent Care Clinic/Center
  • South Plainfield, NJ
  • NPI 1851733349
  Medicare reassignment NPD
• St. Joseph's Healthcare, Inc.

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1497791297
  Medicare reassignment NPD
• Browne Medical, LLC

  • Urgent Care Clinic/Center
  • West Orange, NJ
  • NPI 1871935353
  NPD (past)
• St Josephs University Medical Center Inc.

  • General Acute Care Hospital
  • Paterson, NJ
  • NPI 1669462420
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Josephs University Medical Center Inc.

  • General Acute Care Hospital
  • Paterson, NJ
  • NPI 1669462420
  Care Compare affiliation

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

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413763200000",
    "number": "1427452465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 MAIN ST STE C",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032244",
            "telephone_number": "862-336-1200",
            "fax_number": "862-236-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 MAIN ST STE C",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032244",
            "telephone_number": "862-336-1200",
            "fax_number": "862-236-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOROUDI",
        "first_name": "SHIDEH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-20",
        "last_updated": "2014-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA09499400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Donaway, MD
• Ann Elizabeth Doniguian, M.D.
• Madison Renee Donovan, DO
• Rita Donyina-Ameyaw, NP
• Dimitrios Vasilios Doris, D.C.
• Desira Douglas
• Karen L Douglas, LCADC
• Dr Luis F Luna MD LLC
• Dr Luis F Luna MD LLC
• Dr Mathias Zemel, LLC

• Family Medicine Physician in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; 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.
• 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.