Individual provider Active NPI

Dorothy Ozurumba, NP

  • Adult Health Nurse Practitioner
  • Somerset, NJ
National Provider Identifier
1962609909
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00024900 Issued in NJ
Practice address
1075 Easton Ave Ste 11-258
Somerset, NJ 08873-1648
Phone
(848) 237-9715
NPI assigned
Jul 2, 2007
Last updated
Dec 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00024900 NJ Primary

Addresses

Primary practice location

1075 Easton Ave Ste 11-258
Somerset, NJ 08873-1648

Mailing address

1075 Easton Ave Ste 11-630
Somerset, NJ 08873-1648
Phone (848) 237-9715

Other identifiers 1

IdentifierTypeStateIssuer
0250376MedicaidNJ

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110622000197 NJ Practitioner - Nurse Practitioner 6103004114 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical Group PCGroup PAC ID 8628470325, 217 clinicians

Practice addresses (Care Compare)

703 Main St
Paterson, NJ 07503-2621
Phone (973) 754-6331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00024900NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Josephs Medical Group PC CurrentSince Nov 2, 2021 Accepting new patients
St. Joseph's Healthcare, Inc. CurrentSince Dec 1, 2014 Accepting new patients

Locations

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

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

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1962609909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 EASTON AVE STE 11-630",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731648",
            "telephone_number": "848-237-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 EASTON AVE STE 11-258",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731648",
            "telephone_number": "848-237-9715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OZURUMBA",
        "first_name": "DOROTHY",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00024900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0250376",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

Verify at the official NPI Registry.