NPIMap

Dylan Francis Roden, MD, MPH

Individual provider Active NPI Otolaryngology Physician · Newark, NJ

NPI 1649618596 · NPPES record last updated Sep 10, 2019

Key facts

NPI
1649618596
Entity type
Individual (NPI type 1)
Primary specialty
Otolaryngology Physician 207Y00000X
License
25MA10604600 (NJ)
Practice address
90 Bergen St # 8100
Newark, NJ 07103
Phone
(973) 972-2548
Fax
(973) 972-8567
NPI assigned
Jun 12, 2013
Sex
Male
Sole proprietor
No

Organizations & group practices 17

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.

Medicare Care Compare profile

Specialty
Otolaryngology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physician Associates of New Jersey Inc (374 clinicians)

Practice addresses (Care Compare)

140 Bergen St
Newark, NJ 07103-2425
Phone (973) 972-9000

30 Bergen St
Newark, NJ 07107-3000
Phone (973) 972-0037

Hospital & facility affiliations

  • The University Hospital Hospital · Newark, NJ · CCN 310119
  • Cooperman Barnabas Medical Center Hospital · Livingston, NJ · CCN 310076

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20190909000256 NJ Practitioner - Otolaryngology 4880940287 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD463958PAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc Otolaryngology Current
since Sep 9, 2019		 Accepting new patients
University Physician Associates of New Jersey Inc Current
since Sep 9, 2019		 Accepting new patients
University Physician Associates of New Jersey Inc Past Accepting new patients
University Hospital Past Accepting new patients

Locations

200 S Orange Ave
Ste 150
Livingston, NJ 07039
Phone (973) 322-7000

140 Bergen St
Newark, NJ 07103
Phone (973) 972-0320

90 Bergen St
#8100
Newark, NJ 07103
Phone (973) 972-2323

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

30 Bergen St
Rm 1205
Newark, NJ 07107
Phone (973) 972-0037

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD463958 PA
Otolaryngology Physician 207Y00000X 25MA10604600 NJ Yes

Addresses

Primary practice location

90 Bergen St # 8100
Newark, NJ 07103

Mailing address

30 Bergen St RM 1205
Newark, NJ 07107-3000

Other practice location 1

925 Chestnut St Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 10, 2019.

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1649618596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BERGEN ST RM 1205",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071073000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BERGEN ST # 8100",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07103",
            "telephone_number": "973-972-2548",
            "fax_number": "973-972-8567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Chestnut St Fl 6",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "19107",
            "country_code": "US",
            "telephone_number": "215-955-6760",
            "fax_number": "215-923-4532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODEN",
        "first_name": "DYLAN",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD463958",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": "25MA10604600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

All providers in Newark, NJ · Otolaryngology Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.