Dimitri Laddis, MD

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

25MA10557500 Issued in NJ

Practice address

481 S Washington Ave
Bergenfield, NJ 07621-4313

Phone

(201) 875-2454

Fax

(732) 707-5001

NPI assigned

Jul 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dimitri.laddis.1@27996.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Passaic River Observation, LLC

  • Emergency Medicine Physician
  • Paterson, NJ
  • NPI 1568113348
  Medicare reassignment NPD
• Passaic River Physicians, LLC

  • Emergency Medicine Physician
  • Paterson, NJ
  • NPI 1962162644
  Medicare reassignment NPD
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152

  Pediatrics

  Medicare reassignment NPD
• Nextgenuc LLC

  • Pediatrics Physician
  • Bergenfield, NJ
  • NPI 1295449007
  NPD Authorized official
• Nextgenuc LLC

  • Urgent Care Clinic/Center
  • Bergenfield, NJ
  • NPI 1407457880
  NPD Authorized official
• Passaic River Physicians, LLC

  • Emergency Medicine Physician
  • Wayne, NJ
  • NPI 1124788807
  NPD
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD
• Mount Sinai School of Medicine

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1891757340
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687046400000",
    "number": "1760415384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 LIBERTY ST",
            "city": "PIERMONT",
            "state": "NY",
            "postal_code": "109681207",
            "telephone_number": "917-974-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 S WASHINGTON AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076214313",
            "telephone_number": "201-875-2454",
            "fax_number": "732-707-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADDIS",
        "first_name": "DIMITRI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2023-06-18",
        "certification_date": "2023-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "2288751",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NY",
            "license": "228875",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "NJ",
            "license": "25MA10557500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY LICENSE",
            "identifier": "25MA10557500",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02461127",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• La Paula at Main LLC
• La Paula Health Care Service Corp
• La Paula Health Care Services
• La Paula Manor Corporation
• Mariliza Lacap, D.D.S.
• Jessica Landa, BS OT
• Laser Eye Institute of New Jersey, LLC
• Gregory Law, MD
• LCN Medical Group
• Murray Joseph Leben, D.M.D.

• Pediatric Emergency Medicine (Pediatrics) Physician in Bergenfield, NJ
• Providers in Bergenfield, NJ by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.