Active NPI
Mirna Bury, PAC
- Physician Assistant
- Jersey City, NJ
National Provider Identifier
1043494107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 25MP00088600
- Practice address
- 193 Palisade Ave
Jersey City, NJ 07306-1112 - Phone
- (201) 656-1042
- Fax
- (201) 656-7656
- NPI assigned
- Dec 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00088600 | NJ | Primary |
Addresses
Primary practice location
193 Palisade Ave
Jersey City, NJ 07306-1112
Mailing address
193 Palisade Ave
Jersey City, NJ 07306-1112
Phone (201) 656-1042
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP0006600 | NJ | MD | Physician Assistant |
Interoperability endpoints
- mirna.bury@direct.carepointhealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198627200000",
"number": "1043494107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "193 PALISADE AVE",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073061112",
"telephone_number": "201-656-1042",
"fax_number": "201-656-7656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "193 PALISADE AVE",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073061112",
"telephone_number": "201-656-1042",
"fax_number": "201-656-7656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURY",
"first_name": "MIRNA",
"credential": "PAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-26",
"last_updated": "2007-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00088600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.