Individual provider Active NPI

Nabil Dahrouj, M.D.

  • Pediatrics Physician
  • Bayonne, NJ
National Provider Identifier
1720285331
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA08487500 Issued in NJ
Practice address
834 Avenue C
Bayonne, NJ 07002-2975
Phone
(201) 339-4222
NPI assigned
Jun 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA08487500 NJ Primary

Addresses

Primary practice location

834 Avenue C
Bayonne, NJ 07002-2975

Mailing address

80 Union Ave Apt A7
Clifton, NJ 07011-2661
Phone (973) 653-6396

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
I20111206000149 NJ Practitioner - Pediatric Medicine 8527233394 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08487500NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care of New Jersey PC Pediatrics CurrentSince Dec 23, 2018 Accepting new patients
Humc Opco LLC Current Accepting new patients
Garden State Healthcare Associates, LLC CurrentSince Oct 26, 2011 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Dec 23, 2018 Accepting new patients
A.G. Dikengil, MD, PA Past Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

38 Meadowlands Pkwy
Ste 205
Secaucus, NJ 07094
Phone (201) 552-2357

3403 S Delsea Dr
Vineland, NJ 08360
Phone (856) 293-6974

Interoperability endpoints

  • Direct secure messaging: ndahrouj@direct.hobokenumc.md

Organizations & group practices 5

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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1720285331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 UNION AVE APT A7",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112661",
            "telephone_number": "973-653-6396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 AVENUE C",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070022975",
            "telephone_number": "201-339-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHROUJ",
        "first_name": "NABIL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA08487500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

Verify at the official NPI Registry.