Organization Active NPI

North Jersey Infectious Disease Group LLC

  • Infectious Disease Physician
  • Englewood, NJ
National Provider Identifier
1043362940
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MA62848 Issued in NJ
Legal business name
NORTH JERSEY INFECTIOUS DISEASE GROUP LLC
Practice address
200 Grand Ave
Suite 102
Englewood, NJ 07631-4371
Phone
(201) 503-0660
Fax
(201) 503-0685
NPI assigned
Jan 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Dr. Mihran A Seferian, M.D.NPI 1821198805
Title
Member
Phone
(201) 503-0660

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X MA62848 NJ Primary

Addresses

Primary practice location

200 Grand Ave
Suite 102
Englewood, NJ 07631-4371

Mailing address

200 Grand Ave
Suite 102
Englewood, NJ 07631-4371
Phone (201) 503-0660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080513000084 NJ Part B Supplier - Clinic/Group Practice 4880763184 Receives reassigned benefits from 2 practitioners
Practice locations: Englewood, NJ

National Provider Directory

National Provider Directory

Locations

200 Grand Ave
Ste 102
Englewood, NJ 07631
Phone (201) 481-7160

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1043362940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GRAND AVE",
            "address_2": "SUITE 102",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314371",
            "telephone_number": "201-503-0660",
            "fax_number": "201-503-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GRAND AVE",
            "address_2": "SUITE 102",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076314371",
            "telephone_number": "201-503-0660",
            "fax_number": "201-503-0685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH JERSEY INFECTIOUS DISEASE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "SEFERIAN",
        "authorized_official_first_name": "MIHRAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "201-503-0660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "MA62848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.