Roberto A Jodorkovsky, M.D.

Primary specialty

Pediatric Nephrology PhysicianTaxonomy code 2080P0210X

License

25MA-08729000 Issued in NJ

Practice address

703 Main St
Paterson, NJ 07503-2621

Phone

(973) 754-2547

Fax

(973) 754-2628

NPI assigned

Jun 7, 2006

Last updated

Jun 17, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

NephrologyAlso: Pediatric Medicine

Education

Other, 1974

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)

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
• St. Joseph's Healthcare, Inc.

  • Internal Medicine Physician
  • Paterson, NJ
  • NPI 1497791297
  Medicare reassignment NPD
• TBHC Pediatric Services PC

  • Pediatrics Physician
  • Brooklyn, NY
  • NPI 1861628091

  Pediatric Nephrology

  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276732800000",
    "number": "1457391880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-2547",
            "fax_number": "973-754-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075032621",
            "telephone_number": "973-754-2547",
            "fax_number": "973-754-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JODORKOVSKY",
        "first_name": "ROBERTO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2010-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "NJ",
            "license": "25MA-08729000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jersey Foot and Ankle Clinic, LLC
• Jhonsua a Jimenez Arias MD, LLC
• Gerson Lisandro Jimenez
• Jonathan David Jimenez, D.O
• Sasha Jimenez
• Gregory James Johanning
• John J Messina, MD, PC
• John J Zisa
• John P Holland Charter School
• Reshma K John

• Pediatric Nephrology Physician in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Pediatric Nephrology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; 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.