Individual provider Active NPI

Arry Dieudonne, MD

  • Pediatric Infectious Diseases Physician
  • Newark, NJ
National Provider Identifier
1649349333
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
25MA25873300 Issued in NJ
Practice address
150 Bergen St
G102
Newark, NJ 07103-2496
Phone
(973) 972-0380
Fax
(973) 972-6443
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X 25MA25873300 NJ Primary

Addresses

Primary practice location

150 Bergen St
G102
Newark, NJ 07103-2496

Mailing address

30 Bergen St
Admc 12 1205
Newark, NJ 07107-3000

Other identifiers 1

IdentifierTypeStateIssuer
6690700MedicaidNJ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adieudonne4458@direct.uhnj.org Direct University Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120308000692 NJ Practitioner - Pediatric MedicinePractitioner - Infectious Disease 1850550930 Reassigns benefits to 1 organization
I20170412002361 NY Practitioner - Emergency Medicine 1850550930 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA25873300NJMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc CurrentSince Nov 6, 1995 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Nov 6, 1995 Accepting new patients
Bronxcare Health System CurrentSince Mar 4, 2017 Accepting new patients
Bronxcare Health System CurrentSince Mar 4, 2017 Accepting new patients

Locations

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

90 Bergen St
Newark, NJ 07103
Phone (973) 972-0037

150 Bergen St
#G102
Newark, NJ 07103
Phone (973) 972-0380

30 Bergen St
#12
Newark, NJ 07107
Phone (973) 972-0037

1276 Fulton Ave
Rm 208
Bronx, NY 10456
Phone (718) 901-8918

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1650 Grand Concourse
Fl 1
Bronx, NY 10457
Phone (718) 518-5340

Organizations & group practices 4

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1649349333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BERGEN ST",
            "address_2": "ADMC 12 1205",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST",
            "address_2": "G102",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-0380",
            "fax_number": "973-972-6443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEUDONNE",
        "first_name": "ARRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "NJ",
            "license": "25MA25873300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6690700",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adieudonne4458@direct.uhnj.org",
            "affiliation": "Y",
            "endpointDescription": "EPIC",
            "affiliationName": "University Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "150 Bergen St",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071032496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.