Individual provider Active NPI

Olga M Maimon, M.D.

  • Gastroenterology Physician
  • East Brunswick, NJ
National Provider Identifier
1073598850
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MA078252 Issued in NJ
Practice address
758 Route 18 Ste 103a
East Brunswick, NJ 08816-4923
Phone
(732) 360-0117
Fax
(732) 360-1141
NPI assigned
Dec 14, 2005
Last updated
Oct 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MA078252 NJ Primary

Addresses

Primary practice location

758 Route 18 Ste 103a
East Brunswick, NJ 08816-4923

Mailing address

758 Route 18 Ste 103a
East Brunswick, NJ 08816-4923
Phone (732) 360-0117

Other identifiers 1

IdentifierTypeStateIssuer
0071595MedicaidNJ

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
I20050809000242 NJ Practitioner - Gastroenterology 3678535002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

758 Rte 18
Suite 103
East Brunswick, NJ 08816-4910
Phone (732) 360-0117

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy105
Upper gastrointestinal (GI) endoscopy for acid reflux103

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA078252NJMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osprey Hospice LLC Current Accepting new patients
Olga M Maimon MD PC Gastroenterology CurrentSince Jul 1, 2005 Accepting new patients

Locations

758 Route 18
Ste 103
East Brunswick, NJ 08816
Phone (732) 360-0117

758 State Route 18
Ste 103A
East Brunswick, NJ 08816
Phone (732) 360-9996

3 Hospital Plz
Ste 405
Old Bridge, NJ 08857
Phone (732) 360-1133

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Spero Hospice & Palliative CareEast Brunswick, NJ, CCN 311593 Hospice 5% Or Greater Direct Ownership Interest (100%)
5% Or Greater Security Interest (100%)
Corporate Officer (100%)
W-2 Managing Employee (100%)
Operational/Managerial Control (100%)
Apr 17, 2023
Apr 17, 2023
Apr 17, 2023
Apr 17, 2023
Apr 17, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1073598850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 ROUTE 18 STE 103A",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088164923",
            "telephone_number": "732-360-0117",
            "fax_number": "732-360-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 ROUTE 18 STE 103A",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088164923",
            "telephone_number": "732-360-0117",
            "fax_number": "732-360-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIMON",
        "first_name": "OLGA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "MA078252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0071595",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.