Montclair Adult Care

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

25MA08463200 Issued in NJ

Legal business name

MONTCLAIR ADULT CARE

Practice address

239 Claremont Ave
Montclair, NJ 07042-2833

Phone

(973) 338-3300

Fax

(973) 338-0400

NPI assigned

Oct 15, 2010

Organization subpart

No

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

Authorized official

Name

Rekha MiryalaNPI 1942486568

Title

MD

Phone

(973) 338-3300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FAJACA

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rekha Miryala, M.D

  • Internal Medicine Physician
  • Bloomfield, NJ
  • NPI 1942486568
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400544000000",
    "number": "1033429758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 CLAREMONT AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422833",
            "telephone_number": "973-338-3300",
            "fax_number": "973-338-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 CLAREMONT AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422833",
            "telephone_number": "973-338-3300",
            "fax_number": "973-338-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTCLAIR ADULT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-15",
        "last_updated": "2014-05-20",
        "status": "A",
        "authorized_official_last_name": "MIRYALA",
        "authorized_official_first_name": "REKHA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "973-338-3300"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08463200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yasmeen Mitchell
• Luis Mizraji, DC
• Janel Modoski
• Frank Molignano, CCH, RSHOM(NA)
• Anne Mathias Monsees
• Montclair Ambulance Unit
• Montclair Anesthesia Associates, P.C.
• Montclair Anesthesia Group
• Montclair Anesthesia Group
• Montclair Art Museum

• Internal Medicine Physician in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.