Individual provider Active NPI

Mimi Nu Ton, M.D.

  • Pediatric Gastroenterology Physician
  • Newark, NJ
National Provider Identifier
1033178355
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
25MA08064000 Issued in NJ
Practice address
201 Lyons Ave
Newark, NJ 07112-2027
Phone
(973) 926-4446
Fax
(973) 705-3148
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 218892 NY
Pediatric Gastroenterology Physician 2080P0206X 25MA08064000 NJ Primary

Addresses

Primary practice location

201 Lyons Ave
Newark, NJ 07112-2027

Mailing address

28 W 3Rd St
Apartment 1419
South Orange, NJ 07079-1782
Phone (973) 763-6340

Other identifiers 1

IdentifierTypeStateIssuer
02580936MedicaidNY

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
I20060911000506 NJ Practitioner - Pediatric MedicinePractitioner - Gastroenterology 3678534534 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218892NYMDPediatrics Physician
25MA08064000NJMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Observation Associates LLC CurrentSince Oct 28, 2023 Accepting new patients
University Physician Associates of New Jersey Inc Pediatrics CurrentSince Sep 30, 2022 Accepting new patients
University Physician Associates of New Jersey Inc CurrentSince Sep 30, 2022 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Dec 31, 2012 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Dec 31, 2012 Accepting new patients
Specialist Peds at Lich Pediatric Gastroenterology Past Accepting new patients
NJ Children'S Hospital Medical Group Pediatrics Past Accepting new patients

Locations

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

200 S Orange Ave
Livingston, NJ 07039
Phone (973) 322-7007

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

235 Millburn Ave
Ste 101
Millburn, NJ 07041
Phone (973) 376-8034

201 Lyons Ave
Ste C9
Newark, NJ 07112
Phone (973) 926-7203

201 Lyons Ave
Ste L5
Newark, NJ 07112
Phone (973) 926-3500

90 Bergen St
Newark, NJ 07103
Phone (973) 972-0037

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833

1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763

375 Mount Pleasant Ave
West Orange, NJ 07052
Phone (973) 322-6900

375 Mount Pleasant Ave
Ste 105
West Orange, NJ 07052
Phone (973) 322-6900

Interoperability endpoints

  • Direct secure messaging: mton75210@epicdirect.rwjbh.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1033178355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 W 3RD ST",
            "address_2": "APARTMENT 1419",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791782",
            "telephone_number": "973-763-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-4446",
            "fax_number": "973-705-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TON",
        "first_name": "MIMI",
        "middle_name": "NU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "218892",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NJ",
            "license": "25MA08064000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02580936",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.