Individual provider Active NPI

Daniel P Conroy Jr., M.D.

  • Cardiovascular Disease Physician
  • Clifton, NJ
National Provider Identifier
1629098603
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA03380100 Issued in NJ
Practice address
1033 Clifton Ave
Clifton, NJ 07013-3517
Phone
(201) 460-0142
Fax
(973) 473-7085
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MA03380100 NJ Primary

Addresses

Primary practice location

1033 Clifton Ave
Clifton, NJ 07013-3517

Mailing address

1033 Clifton Ave
Clifton, NJ 07013-3517
Phone (201) 460-0142

Other identifiers 1

IdentifierTypeStateIssuer
4669002MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050908000068 NJ Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5698728111 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys General Medical Group PCGroup PAC ID 5496112476, 73 clinicians

Practice addresses (Care Compare)

350 Boulevard
Passaic, NJ 07055-2840
Phone (973) 365-4300

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
GHCP Ekg Interpretation Panel, LLC CurrentSince Dec 11, 2001 Accepting new patients
St Marys General Medical Group PC CurrentSince Aug 1, 2024 Accepting new patients

Locations

1033 Clifton Ave
Clifton, NJ 07013
Phone (973) 473-5700

1033 Clifton Ave
Ste 102
Clifton, NJ 07013
Phone (973) 777-2005

350 Boulevard
Fl 1
Passaic, NJ 07055
Phone (973) 365-7143

350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1629098603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133517",
            "telephone_number": "201-460-0142",
            "fax_number": "973-473-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133517",
            "telephone_number": "201-460-0142",
            "fax_number": "973-473-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONROY",
        "first_name": "DANIEL",
        "middle_name": "P",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA03380100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4669002",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.