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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

THEODORE J SOUTHGATE MD
NPI 1730156217
Internal Medicine - Cardiovascular Disease in Newark, NJ

Active since March 03, 2006PECOS Enrolled
93.71/100
CMS Quality Rating
201 LYONS AVE, SUITE G5, NEWARK, NJ 07112(973) 926-7749(973) 923-4683 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Theodore J Southgate Md NPPES

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

THEODORE J SOUTHGATE MD (NPI 1730156217) is an individual cardiovascular disease provider in Newark, New Jersey, licensed in New Jersey (25MA05005700) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Newark Beth Israel Medical Center, and is a graduate of University Of Michigan Medical School (1980).

NPPES Registry Identity

NPI1730156217
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameTHEODORE J SOUTHGATECredential: MD
Location Address201 LYONS AVE, SUITE G5Newark, NJ 07112-2027
Mailing Address201 Lyons Ave, Suite G5Newark, NJ 07112-2027 · (973) 926-7749 · Fax (973) 923-4683
Phone(973) 926-7749
Fax(973) 923-4683
Sole ProprietorNo
Medical School CMSUniversity Of Michigan Medical SchoolGraduated 1980
Enumeration DateMarch 3, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1730156217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in NJ · 25MA05005700
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
201 LYONS AVE, Newark, NJ 07112
Open in Google Maps ↗

Other Identifiers 1

Medicaid7459106NJ

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Theodore J Southgate Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698713980
PECOS Enrollment IDI20050418001107
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Newark Beth Israel Medical Center

Acute Care Hospitals · Newark, NJ
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310002
Location201 Lyons AveNewark, NJ 07112 · Essex County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07112 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$144.86 typical visit price
range $63.84 – $190.92
Typical copayment $36.21 (range $15.96 – $47.73)
Most-billed visit code 99204
Established Patient
$79.09 typical visit price
range $20.97 – $155.92
Typical copayment $19.77 (range $5.24 – $38.98)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

93.71/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality77.79
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KEITH MICHAEL SPELLMAN M.D.
Radiology (Diagnostic Radiology)
201 LYONS AVE
NEWARK, NJ 07112
Essex County (973) 926-7960
DR. LARISSA SOPHIA DUDLEY M.D.
Emergency Medicine
201 LYONS AVE, SUITE D11
NEWARK, NJ 07112
Essex County (973) 926-6671
WAQAS BARI MD
Student in an Organized Health Care Education/Training Program
201 LYONS AVE
NEWARK, NJ 07112
Essex County (800) 843-2384
ERIKA YESENIA PINEDA MD
Pediatrics (Pediatric Critical Care Medicine)
201 LYONS AVE
NEWARK, NJ 07112
Essex County (973) 926-7000
CASEY YEONJOO CHO APN
Nurse Practitioner (Acute Care)
201 LYONS AVE
NEWARK, NJ 07112
Essex County (973) 926-6938
KARLINA NGUYEN PA-C
Physician Assistant
201 LYONS AVE
NEWARK, NJ 07112
Essex County (973) 926-7000
GARY LAYTON DDS
Student in an Organized Health Care Education/Training Program
201 LYONS AVE
NEWARK, NJ 07112
Essex County (973) 926-7642
DR. ALEXIS LORDI MD
Student in an Organized Health Care Education/Training Program
201 LYONS AVE
NEWARK, NJ 07112
Essex County (973) 900-4855

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 Theodore Southgate's NPI number?

The NPI number for Theodore Southgate is 1730156217. It was assigned to this individual provider in the NPPES registry on March 3, 2006.

Where is Theodore Southgate located?

Theodore Southgate practices at 201 Lyons Ave Suite G5, Newark, NJ 07112. The listed phone number is (973) 926-7749.

What is Theodore Southgate's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Theodore Southgate enrolled in Medicare?

Yes. Theodore Southgate is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Theodore Southgate affiliated with any hospitals?

According to CMS data, Theodore Southgate is affiliated with Newark Beth Israel Medical Center.

When was this NPI record last updated?

The NPPES record for Theodore Southgate was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days 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.