Individual provider Active NPI

Elda P Sancho Mora, M.D

  • Forensic Psychiatry Physician
  • Morris Plains, NJ
National Provider Identifier
1003972423
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
License
25MA08083900 Issued in NJ
Practice address
59 Koch Ave
Morris Plains, NJ 07950-4400
Phone
(973) 538-1800
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 222291 NY
Forensic Psychiatry Physician 2084F0202X 25MA08083900 NJ Primary

Addresses

Primary practice location

59 Koch Ave
Morris Plains, NJ 07950-4400

Mailing address

451 Walton Rd
Maplewood, NJ 07040-1119
Phone (718) 541-2750

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
I20070904000393 NJ Practitioner - Psychiatry 4284727454 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

Hospital & facility affiliations

  • Morristown Medical Center Hospital, Morristown, NJ, CCN 310015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
222291NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NJ Memory and Behavioral Care Psychiatry CurrentSince Oct 1, 2019 Accepting new patients
Ahs Hospital Corp. Past Accepting new patients

Locations

14 Ridgedale Ave
Ste 103
Cedar Knolls, NJ 07927
Phone (973) 295-6335

575 Route 28
Bldg 2
Raritan, NJ 08869
Phone (973) 295-6335

Interoperability endpoints

  • Direct secure messaging: njmemoryandbehavioralcare.eldasanchomora@135306.advancedmd-direct.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1003972423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 WALTON RD",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070401119",
            "telephone_number": "718-541-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 KOCH AVE",
            "city": "MORRIS PLAINS",
            "state": "NJ",
            "postal_code": "079504400",
            "telephone_number": "973-538-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHO MORA",
        "first_name": "ELDA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "222291",
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "NJ",
            "license": "25MA08083900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morris Plains, NJ

Sources for this page

Verify at the official NPI Registry.