Individual provider Active NPI

Doreen Evelyn Degraaff, M.D.

  • Obstetrics & Gynecology Physician
  • West Orange, NJ
National Provider Identifier
1629142401
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MA05472200 Issued in NJ
Practice address
375 Mount Pleasant Ave
West Orange, NJ 07052-2750
Phone
(973) 731-7707
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 25MA05472200 NJ Primary

Addresses

Primary practice location

375 Mount Pleasant Ave
West Orange, NJ 07052-2750

Mailing address

375 Mount Pleasant Ave
West Orange, NJ 07052-2750
Phone (973) 731-7707

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
I20050207000742 NJ Practitioner - Obstetrics/Gynecology 4284685231

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Rutgers New Jersey Medical School, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

150 Floral Ave
New Providence, NJ 07974-1557

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Mar 14, 2013 Accepting new patients
Summit Medical Group PA CurrentSince Mar 14, 2013 Accepting new patients
Summit Medical Group, Inc Obstetrics & Gynecology Past Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

150 Floral Ave
New Providence, NJ 07974
Phone (908) 588-3890

Interoperability endpoints

  • Direct secure messaging: doreen.degraaff.1@2983.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1629142401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 MOUNT PLEASANT AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522750",
            "telephone_number": "973-731-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 MOUNT PLEASANT AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522750",
            "telephone_number": "973-731-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRAAFF",
        "first_name": "DOREEN",
        "middle_name": "EVELYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA05472200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.