Individual provider Active NPI

Steven Barry Eagle, MD

  • Pediatrics Physician
  • Woodbury, NJ
National Provider Identifier
1609012806
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA08737400 Issued in NJ
Practice address
509 N Broad St
Woodbury, NJ 08096-1617
Phone
(856) 845-0100
Fax
(302) 651-4945
NPI assigned
Dec 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA08737400 NJ Primary
Pediatrics Physician 208000000X 257724 NY

Addresses

Primary practice location

509 N Broad St
Woodbury, NJ 08096-1617

Mailing address

PO Box 191
Provider Enrollment
Rockland, DE 19732-0191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
257724NYMDLicensed Practical Nurse
25MA08737400NJMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1609012806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N BROAD ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961617",
            "telephone_number": "856-845-0100",
            "fax_number": "302-651-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGLE",
        "first_name": "STEVEN",
        "middle_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-18",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA08737400",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "257724",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

Verify at the official NPI Registry.