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BAYONNE PEDIATRIC PRACTICE
NPI 1427416304
Pediatrics in Bayonne, NJ

Active since February 05, 2016CLIA 31D2110171 · Waiver
765 KENNEDY BLVD, BAYONNE, NJ 07002(201) 823-4141 Get Directions Write a Review

NPPES record last updated: December 10, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 10, 2021, Jul 13, 2018, Sep 15, 2016 and 1 more (4 updates tracked since 2016).

About Bayonne Pediatric Practice NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BAYONNE PEDIATRIC PRACTICE (NPI 1427416304) is a healthcare organization registered as a pediatrics in Bayonne, New Jersey and active in the NPI registry since February 2016. The organization holds a CLIA Waiver certificate valid through March 9, 2028 and lists Shalini Nagarajan Raghu, Owner, as its authorized official.

NPPES Registry Identity

NPI1427416304
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameBAYONNE PEDIATRIC PRACTICE
Location Address765 KENNEDY BLVDBayonne, NJ 07002
Mailing Address21 Tamarack RdEdison, NJ 08820-3630 · (201) 823-4141 · Fax (201) 823-1141
Phone(201) 823-4141
Organization SubpartNo
Authorized OfficialShalini Nagarajan RaghuOwner · (201) 823-4141
Enumeration DateFebruary 5, 2016
Last NPPES UpdateDecember 10, 20214 updates tracked since enumeration
NPPES CertifiedDecember 10, 2021
✔ NPI 1427416304 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NJ · 25MA08140300
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
765 KENNEDY BLVD, Bayonne, NJ 07002
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 31D2110171

Bayonne Pediatric Practice · Bayonne, NJ
Active · expires Mar 9, 2028
CLIA Number31D2110171
Laboratory TypePhysician Office
Certificate Effective DateMarch 10, 2026
Certificate Expiration DateMarch 9, 2028
Laboratory DirectorShalini N. Raghu
Laboratory Phone(201) 823-4141
Laboratory LocationBayonne Pediatric Practice765 John F Kennedy Boulevard, Bayonne, NJ 07002
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bayonne Pediatric Practice's NPI number?

The NPI number for Bayonne Pediatric Practice is 1427416304. It was assigned to this organization in the NPPES registry on February 5, 2016.

Where is Bayonne Pediatric Practice located?

Bayonne Pediatric Practice is located at 765 Kennedy Blvd, Bayonne, NJ 07002. The listed phone number is (201) 823-4141.

What is Bayonne Pediatric Practice's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Bayonne Pediatric Practice hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 31D2110171) is associated with this NPI, valid through March 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bayonne Pediatric Practice was last updated on December 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.