Individual provider Active NPI

Maria Theresa Alvarez-Ballway, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Newark, NJ
National Provider Identifier
1750508149
Registry record updated Apr 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
25MA05778100 Issued in NJ
Practice address
150 Bergen St
Pediatric E.R
Newark, NJ 07103-2496
Phone
(973) 972-5139
Fax
(973) 972-5965
NPI assigned
Apr 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 25MA05778100 NJ Primary

Addresses

Primary practice location

150 Bergen St
Pediatric E.R
Newark, NJ 07103-2496

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
6604609MedicaidNJ

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
I20190423001259 NJ Practitioner - Emergency Medicine 9638411648 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05778100NJMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Medical Group PC CurrentSince Nov 1, 2021 Accepting new patients
Passaic River Physicians, LLC CurrentSince Jun 1, 2022 Accepting new patients
St. Joseph'S Emergency Physicians Inc CurrentSince Apr 8, 2019 Accepting new patients
St. Joseph'S Healthcare, Inc. CurrentSince Jun 10, 2019 Accepting new patients
Passaic River Physicians, LLC Current Accepting new patients

Locations

703 Main St
Bldg 400
Paterson, NJ 07503
Phone (973) 754-2054

703 Main St
Rm XG2126
Paterson, NJ 07503
Phone (973) 754-2240

703 Main St
#G
Paterson, NJ 07503
Phone (973) 754-6331

703 Main St
Rm XG21
Paterson, NJ 07503
Phone (973) 754-2240

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1750508149",
    "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": "PEDIATRIC E.R",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-5139",
            "fax_number": "973-972-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ-BALLWAY",
        "first_name": "MARIA",
        "middle_name": "THERESA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NJ",
            "license": "25MA05778100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6604609",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.