NPIMap

Individual provider Active NPI

Eliezer Aurelina Mordan, MD

  • Emergency Medicine Physician
  • Berkeley Heights, NJ
National Provider Identifier
1003886516
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MA07783600 Issued in NJ
Practice address
1 Diamond Hill Rd FL 1
Berkeley Heights, NJ 07922-2104
Phone
(908) 277-8880
Fax
(908) 277-8796
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MA07783600 NJ Primary

Addresses

Primary practice location

1 Diamond Hill Rd FL 1
Berkeley Heights, NJ 07922-2104

Mailing address

53 Brandon Ave
Monroe, NJ 08831-4043
Phone (856) 912-9750

Other practice location 1

530 New Brunswick Ave
Perth Amboy, NJ 08861-3674
Phone (732) 324-5095

Other identifiers 1

IdentifierTypeStateIssuer
0073067MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050822000965 NJ Practitioner - Emergency Medicine 2163452087 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07783600NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Associates of North Jersey P C Emergency Medicine CurrentSince Feb 1, 2013 Accepting new patients
Summit Medical Group PA CurrentSince Mar 7, 2022 Accepting new patients
Summit Medical Group PA CurrentSince Mar 7, 2022 Accepting new patients
Southern Bank Emergency Physicians LLC Emergency Medicine PastSince Sep 24, 2023 Accepting new patients
Tidal Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

1 Diamond Hill Rd
Fl 1
Berkeley Heights, NJ 07922
Phone (908) 277-8880

530 New Brunswick Ave
Perth Amboy, NJ 08861
Phone (732) 324-5007

1 Riverview Plz
Red Bank, NJ 07701
Phone (732) 530-2204

99 Beauvoir Ave
Summit, NJ 07901
Phone (908) 522-2232

Interoperability endpoints

  • Direct secure messaging: eliezer.mordan.1@2983.direct.athenahealth.com

Organizations & group practices 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1003886516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 BRANDON AVE",
            "city": "MONROE",
            "state": "NJ",
            "postal_code": "088314043",
            "telephone_number": "856-912-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD FL 1",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-277-8880",
            "fax_number": "908-277-8796"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 New Brunswick Ave",
            "address_purpose": "LOCATION",
            "city": "Perth Amboy",
            "state": "NJ",
            "postal_code": "088613674",
            "country_code": "US",
            "telephone_number": "732-324-5095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORDAN",
        "first_name": "ELIEZER",
        "middle_name": "AURELINA",
        "name_prefix": "Miss",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MA07783600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0073067",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Heights, NJ

Sources for this page

Verify at the official NPI Registry.