Individual provider Active NPI

Elena Shteynberg, M.D.

  • Pediatrics Physician
  • Randolph, NJ
National Provider Identifier
1922043116
Registry record updated Mar 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA06797900 Issued in NJ
Practice address
765 Route 10 E
Suite 203
Randolph, NJ 07869-1925
Phone
(973) 659-9991
Fax
(973) 659-9632
NPI assigned
Jun 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2014

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 25MA06797900 NJ Primary

Addresses

Primary practice location

765 Route 10 E
Suite 203
Randolph, NJ 07869-1925

Mailing address

765 Route 10 E
Suite 203
Randolph, NJ 07869-1925
Phone (973) 659-9991

Other identifiers 1

IdentifierTypeStateIssuer
8130001MedicaidNJ

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
25MA06797900NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
College Plaza Pediatrics Pediatrics Past Accepting new patients
Somerset Pediatric Group, LLC Pediatrics PastSince Jun 6, 2021 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": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396051200000",
    "number": "1922043116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 ROUTE 10 E",
            "address_2": "SUITE 203",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078691925",
            "telephone_number": "973-659-9991",
            "fax_number": "973-659-9632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 ROUTE 10 E",
            "address_2": "SUITE 203",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078691925",
            "telephone_number": "973-659-9991",
            "fax_number": "973-659-9632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHTEYNBERG",
        "first_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2014-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA06797900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8130001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2014; 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.