DR. JOSE R FRAGOSO (NPI# 1164497624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164497624 |
| Entity Type | Individual |
| Full Name | DR. JOSE R FRAGOSO |
| Credential | MD |
| Practice Address |
4808 Bergenline Ave 5th Floor Union City NJ 07087-5172 |
| Practice Telephone | 2018653444 |
| Practice Fax Number | 2018650038 |
| Mailing Telephone | 2018653444 |
| Mailing Fax Number | 2018650038 |
| Enumeration Date | 2006-02-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
25MA04358900 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NH | AMERIGROUP | 81801 | 01 |
| NJ | HORIZON NJ HEALTH | 1140004 | 01 |
| NJ | OXFORD | HP080 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528527462 | Jose Montenegro Fragoso | Behavioral Analyst | 5400 Suncrest Dr Ste D1, El Paso, TX 79912-5615 | 2019-03-19 |
| 1578756524 | Jose M. Fragoso | Radiology | 1210 S Old Dixie Hwy, Jupiter, FL 33458-7205 | 2007-08-23 |
| Street Address |
4808 BERGENLINE AVE 5TH FLOOR |
| City | UNION CITY |
| State | NJ |
| Zip Code | 07087-5172 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619236874 | Elham Nasab | Podiatrist | 4808 Bergenline Ave, Ste 202, Union City, NJ 07087-5162 | 2012-05-09 |
| 1508182072 | Premier Psychiatric Consultants | Clinic/Center | 4808 Bergenline Ave, Union City, NJ 07087-5172 | 2010-04-08 |
| 1346452166 | Jose Fragoso Md | Pediatrics | 4808 Bergenline Ave, Union City, NJ 07087-5172 | 2007-05-04 |
| 1013076256 | Debenedictis & Testa, Dpm, Pa | Podiatrist | 4808 Bergenline Ave, Suite 202, Union City, NJ 07087-5162 | 2006-12-06 |
| 1013985951 | Jack Testa | Podiatrist | 4808 Bergenline Ave, Suite 202, Union City, NJ 07087-5172 | 2006-03-08 |
| 1104894054 | Margaret Portela | Podiatrist | 4808 Bergenline Ave, Suite 202, Union City, NJ 07087-5172 | 2006-03-08 |
| 1194792366 | Thomas Henry Debenedictis | Podiatrist | 4808 Bergenline Ave, Suite 202, Union City, NJ 07087-5172 | 2006-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619580107 | Anzule Navarrete | Pediatrics | 3196 John F Kennedy Blvd, Union City, NJ 07087 | 2020-08-25 |
| 1457985491 | Everas Community Services, Inc. | Day Training, Developmentally Disabled Services | 4216 John F. Kennedy Blvd., Union City, NJ 07087 | 2020-02-28 |
| 1699269902 | Amit Amin | Dentist | 3700 John Fitzgerald Kennedy Blvd, Union City, NJ 07087 | 2018-06-20 |
| 1083120570 | Ah Medical PC | Psychiatry & Neurology | 3600 Bergenline Ave 2nd Floor, Ste 8, Union City, NJ 07087 | 2017-12-19 |
| 1225547862 | Coxphit LLC | Respite Care | 809 22nd Street, Unit 506, Union City, NJ 07087 | 2017-09-27 |
| 1811415433 | Umaila Iqbal | Physical Therapist | 416 Bay Ridge Parkway, Brooklyn, NY 07087 | 2017-09-04 |
| 1952853962 | Curren M Whitfield | Social Worker | 400 38th St Ste 222, Union City, NJ 07087 | 2016-10-26 |
| 1811340854 | Karen Samaniego | Social Worker | 2201 Bergenline Avenue Union City, Nj, Union City, NEW JERSEY 07087 | 2016-07-14 |
| 1881053072 | Carmen Laura Alejandro-valle | Acupuncturist | 727a 25th Street Apt B2, Union City, NJ 07087 | 2016-02-16 |
| 1295190536 | Jiten Dungarani | Physical Therapist | 500 Central Ave Apt 501, Union City, NJ 07087 | 2015-12-30 |
| Find all providers in zip 07087 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073030953 | Erin Leigh Leonard | Pediatrics | 37 Emerson Road, Glen Rock, NJ 07452 | 2017-08-23 |
| 1104228139 | Joyce Diane Moscaritola | Pediatrics | 6 Castle Court, Randolph, NJ 07869 | 2014-09-22 |
| 1326397803 | Amy Bailon | Pediatrics | 21 Woodbine Rd, Florham Park, NJ 07932-2649 | 2012-08-30 |
| 1487941779 | Sari Bentsianov | Pediatrics | 90 Bergen St Ste 4600, Newark, NJ 07103-2425 | 2011-07-07 |
| 1174789515 | Gerald Martin Klein | Pediatrics | 131 Spinnaker Way, Neptune, NJ 07753-5231 | 2008-08-05 |
| 1043474760 | Amj Pediatrics & Associates | Pediatrics | 18 Morris Ave, #2a, Springfield, NJ 07081-1457 | 2008-07-11 |
| 1033376041 | Deena Rachel Zimmerman | Pediatrics | 1020 Phelps Rd, Teaneck, NJ 07666-5625 | 2008-05-19 |
| 1265605919 | Susan Eleanor Skalsky Bales | Pediatrics | 31 Gladding Road, Caldwell, NJ 07006-5804 | 2008-04-02 |
| 1598944415 | Hanna Gebre Medhin | Pediatrics | 10a W Railroad Ave, Jamesburg, NJ 08831-6783 | 2007-10-26 |
| 1669664298 | Rebecca Perril | Pediatrics | 4000 Route 66, Suite 125, Tinton Falls, NJ 07753-7300 | 2007-08-17 |
| Find all providers with the same taxonomy | ||||
| City | UNION CITY |
| Zip Code | 07087 |
Please comment or provide details below to improve the information on DR. JOSE R FRAGOSO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.