Azza Elbasty, MD, FAAP

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MA058872 Issued in NJ

Practice address

100 Commons Way
Ste 130
Holmdel, NJ 07733-2934

Phone

(732) 615-0700

Fax

(732) 615-9152

NPI assigned

Nov 30, 2006

Sex

Female

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)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Elbasty Pediatric an Denta Assoc.

  • Dentist
  • Holmdel, NJ
  • NPI 1487883559
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588732614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 COMMONS WAY",
            "address_2": "STE 130",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332934",
            "telephone_number": "732-615-0700",
            "fax_number": "732-615-9152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COMMONS WAY",
            "address_2": "STE 130",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077332934",
            "telephone_number": "732-615-0700",
            "fax_number": "732-615-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELBASTY",
        "first_name": "AZZA",
        "name_prefix": "Dr.",
        "credential": "MD, FAAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA058872",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6205305",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Dragun, DSW, LCSW
• Driven2Heal Physical Therapy
• Adriana Dudeck, PA
• Jillian Eisenbraun, P.A. C
• Elbasty Pediatric an Denta Assoc.
• Sarah Elshishiny, BCBA
• Padmaja Eluri, PT
• Leonid Emerel, M.D.
• Emit Therapuetics
• Empowered Life Counseling Services

• Pediatrics Physician in Holmdel, NJ
• Providers in Holmdel, 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 Jul 8, 2007; 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.