Emmanuel Maduabuchi Emelle, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA05990500 Issued in NJ

Practice address

40 Union Ave
Irvington, NJ 07111-3277

Phone

(973) 374-3544

Fax

(973) 374-3554

NPI assigned

Nov 15, 2005

Last updated

Dec 13, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/otCmFR9xLPoc2YGLoEEuj1ulH3uzON_F/

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.

• Emmanuel Emelle, MD. PC.

  • Pediatric Adolescent Medicine Physician
  • Irvington, NJ
  • NPI 1952527723
  NPD (past) Authorized official

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1558343756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 UNION AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113290",
            "telephone_number": "973-374-3544",
            "fax_number": "973-374-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 UNION AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113277",
            "telephone_number": "973-374-3544",
            "fax_number": "973-374-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMELLE",
        "first_name": "EMMANUEL",
        "middle_name": "MADUABUCHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA05990500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6311601",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Educational Center for the Disables. N J Non Profit
• Emmanuella Uju Egeonu
• Oluchi Ekechukwu
• El-Zoenik Supportive Services
• Julie M Elessawi, D.D.S.
• Emmanuel Emelle, MD. PC.
• Empire Ventures
• Empower Care Group Home LLC
• Empower Care LLC
• Empower CBT Counseling LLC

• Pediatrics Physician in Irvington, NJ
• Providers in Irvington, 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 Dec 13, 2011; 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.