Washington Park Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA03289200 Issued in NJ

Legal business name

WASHINGTON PARK PEDIATRICS

Doing business as

KidsCare

Practice address

495 N 13TH St
Newark, NJ 07107-1317

Phone

(973) 268-5862

Fax

(973) 622-3890

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Marc Roberts, M.D.

Title

President

Phone

(973) 622-3890

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• KidsCare Doing business as

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447311493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 BROAD ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071024503",
            "telephone_number": "973-622-3890",
            "fax_number": "973-622-6443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N 13TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071071317",
            "telephone_number": "973-268-5862",
            "fax_number": "973-622-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON PARK PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-622-3890",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA03289200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6618707",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KidsCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Nicole Warren
• Karma Brown Warren, MD
• Melissa Kay Warren, LCSW
• Tracey Warren
• George Wasef
• Washington St Pediatrics LLC
• Washington St Pediatrics LLC
• Cole Tyler Washington, DMD
• Mary Washington
• Katherine Wasserman, FNP-C

• Pediatrics Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.