Individual provider Active NPI

Mayumi A. Mori, M.D.

  • Ophthalmology Physician
  • Cedar Knolls, NJ
National Provider Identifier
1003819905
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
25MA06440500 Issued in NJ
Practice address
218 Ridgedale Ave
Cedar Knolls, NJ 07927-2109
Phone
(973) 326-8895
Fax
(973) 326-6805
NPI assigned
May 24, 2005
Last updated
Aug 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA64405 NJ
Ophthalmology Physician 207W00000X 25MA06440500 NJ Primary

Addresses

Primary practice location

218 Ridgedale Ave
Cedar Knolls, NJ 07927-2109

Mailing address

1265 15TH St
Apt 11G
Fort Lee, NJ 07024-1958
Phone (973) 326-8895

Other identifiers 1

IdentifierTypeStateIssuer
7000901MedicaidNJ

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050901000177 NJ Practitioner - Ophthalmology 3678505401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Icahn School of Medicine at Mount Sinai, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocare, LLCGroup PAC ID 3678562188, 383 clinicians

Practice addresses (Care Compare)

132 Grove St
Suite a
Haddonfield, NJ 08033-1224
Phone (856) 354-2211

138 S Euclid Ave
Advocare Pediatric Ophthalmology
Westfield, NJ 07090-2130
Phone (908) 317-9811

218 Ridgedale Ave
Suite 100
Cedar Knolls, NJ 07927-2109
Phone (973) 326-8895

25 -15 Fair Lawn Ave
Fair Lawn, NJ 07410-3434
Phone (201) 791-3166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA64405NJMDSpecialist
25MA06440500NJMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare, LLC CurrentSince Apr 1, 2013 Accepting new patients
Advocare , LLC CurrentSince Apr 1, 2013 Accepting new patients
Advocare, LLC Past Accepting new patients
Michael S. Mattikow, M.D., P.a. Specialist PastSince Oct 21, 1996 Accepting new patients

Locations

218 Ridgedale Ave
Ste 100
Cedar Knolls, NJ 07927
Phone (973) 292-1113

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

Interoperability endpoints

  • Direct secure messaging: mayumi.mori@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 4

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1003819905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 15TH ST",
            "address_2": "APT 11G",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070241958",
            "telephone_number": "973-326-8895",
            "fax_number": "973-326-6805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 RIDGEDALE AVE",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079272109",
            "telephone_number": "973-326-8895",
            "fax_number": "973-326-6805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORI",
        "first_name": "MAYUMI",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA64405",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA06440500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7000901",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Knolls, NJ

Sources for this page

Verify at the official NPI Registry.