Individual provider Active NPI

Laureto S Bada Jr., MD

  • Anesthesiology Physician
  • Belleville, NJ
National Provider Identifier
1861408593
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA04169900 Issued in NJ
Practice address
One Clara Maass Drive
Belleville, NJ 07109
Phone
(973) 450-2000
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA04169900 NJ Primary

Addresses

Primary practice location

One Clara Maass Drive
Belleville, NJ 07109

Mailing address

11781 Lee Jackson Memorial Hwy
Suite 550
Fairfax, VA 22033-3309
Phone (571) 777-5157

Other identifiers 1

IdentifierTypeStateIssuer
4522907MedicaidNJ

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA04169900NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia (Virginia), LLC Anesthesiology Past Accepting new patients
Anesthesia Associates of NJ LLC Anesthesiology Past Accepting new patients

Organizations & group practices 2

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1861408593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11781 LEE JACKSON MEMORIAL HWY",
            "address_2": "SUITE 550",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333309",
            "telephone_number": "571-777-5157",
            "fax_number": "703-890-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE CLARA MAASS DRIVE",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "07109",
            "telephone_number": "973-450-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADA",
        "first_name": "LAURETO",
        "middle_name": "S",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA04169900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4522907",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.