Khalid Sadrul Anam, M.D.

Individual provider Active NPI Pediatrics Physician · Montclair, NJ

NPI 1669882452 · NPPES record last updated Jan 7, 2026

Key facts

NPI
1669882452
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
25MA10155000 (NJ)
Practice address
314-316 Orange Road
Montclair, NJ 07042
Phone
(862) 213-0769
NPI assigned
May 1, 2014
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA10155000NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tribeca Pediatrics, PLLC Past Accepting new patients
Englewood Hospital and Medical Center Past Accepting new patients
Tribeca Pediatrics Pediatrics Past
since Dec 3, 2023
Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kanam77174@direct.optum.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA10155000 NJ Yes

Addresses

Primary practice location

314-316 Orange Road
Montclair, NJ 07042

Mailing address

314-316 Orange Road
Tribeca Pediatrics
Montclair, NJ 07042
Phone (862) 213-0769

Other practice location 1

9 McWilliams Pl
Jersey City, NJ 07302-1609
Phone (201) 706-7175

Other providers in Montclair, NJ

All providers in Montclair, NJ · Pediatrics Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.