Active NPI
Ulysses Villeza Agpaoa, MD
- Internal Medicine Physician
- Newark, NJ
National Provider Identifier
1457419202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MA058809
- Practice address
- 9 Lincoln Park
Newark, NJ 07102-2301 - Phone
- (973) 375-4634
- Fax
- (973) 926-9164
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MA058809 | NJ | Primary |
| Infectious Disease Physician | 207RI0200X | MA058809 | NJ |
Addresses
Primary practice location
9 Lincoln Park
Newark, NJ 07102-2301
Mailing address
2120 Sycamore St
Bethlehem, PA 18017-5120
Phone (973) 375-4634
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 223698843 | Other | NJ | AETNA |
| 223698843 | Other | NJ | HORIZON |
| 60057421 | Other | NJ | HORIZON NJ HEALTH |
| 01000355301 | Other | NJ | UNITEDHEALTHCARE |
| 01000355302 | Other | NJ | UNITEDHEALTHCARE |
| 7472008 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA058809 | NJ | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465257600000",
"number": "1457419202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2120 SYCAMORE ST",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180175120",
"telephone_number": "973-375-4634",
"fax_number": "973-926-9164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 LINCOLN PARK",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071022301",
"telephone_number": "973-375-4634",
"fax_number": "973-926-9164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGPAOA",
"first_name": "ULYSSES",
"middle_name": "VILLEZA",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2016-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": "MA058809",
"primary": true
},
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "NJ",
"license": "MA058809",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "223698843",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON",
"identifier": "223698843",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON NJ HEALTH",
"identifier": "60057421",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITEDHEALTHCARE",
"identifier": "01000355301",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITEDHEALTHCARE",
"identifier": "01000355302",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7472008",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.