Active NPI
Luisito Garcia De Jesus, M.D.
- Internal Medicine Physician
- Newark, NJ
National Provider Identifier
1801929286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MA060768
- Practice address
- 249 University Ave
RM 104
Newark, NJ 07102-1808 - Phone
- (973) 353-5231
- NPI assigned
- Mar 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MA060768 | NJ | Primary |
Addresses
Primary practice location
249 University Ave
RM 104
Newark, NJ 07102-1808
Mailing address
416 E 11TH St
Apt PH-B
New York, NY 10009-4559
Phone (212) 475-7474
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA060768 | NJ | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801929286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 E 11TH ST",
"address_2": "APT PH-B",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100094559",
"telephone_number": "212-475-7474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "249 UNIVERSITY AVE",
"address_2": "RM 104",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071021808",
"telephone_number": "973-353-5231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE JESUS",
"first_name": "LUISITO",
"middle_name": "GARCIA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": "MA060768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.