Active NPI
Henry A Odujebe, MD
- Emergency Medicine Physician
- Newark, NJ
National Provider Identifier
1487648283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 25MA05474800
- Practice address
- 495 N 13TH St
Newark, NJ 07107-1317 - Phone
- (973) 268-1400
- NPI assigned
- Sep 7, 2005
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 25MA05474800 | NJ | Primary |
| Surgery Physician | 208600000X | 25MA05474800 | NJ | |
| General Practice Physician | 208D00000X | 25MA05474800 | NJ |
Addresses
Primary practice location
495 N 13TH St
Newark, NJ 07107-1317
Mailing address
66 W Gilbert St
Tinton Falls, NJ 07701-4918
Phone (732) 212-0060
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7025106 | Medicaid | NJ | |
| P00357155 | Other | NJ | RAILROAD MEDICARE |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Associates of the North Ward, P.a. | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Newark, NJ
- NPI 1235130238
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289260800000",
"number": "1487648283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 W GILBERT ST",
"city": "TINTON FALLS",
"state": "NJ",
"postal_code": "077014918",
"telephone_number": "732-212-0060"
},
{
"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": "973-268-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODUJEBE",
"first_name": "HENRY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-07",
"last_updated": "2010-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NJ",
"license": "25MA05474800",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NJ",
"license": "25MA05474800",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NJ",
"license": "25MA05474800",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7025106",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00357155",
"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 Nov 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.