Mary T Kondoleon, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

25MA06672300 Issued in NJ

Practice address

32 Clinton St
Paterson, NJ 07522-1775

Phone

(973) 790-6594

NPI assigned

Jun 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Obstetrics/Gynecology

Education

Rutgers New Jersey Medical School, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paterson Community Health Center IncGroup PAC ID 7315007333, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Paterson Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Paterson, NJ
  • NPI 1487694832
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1083643597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 IRONIA RD",
            "city": "MENDHAM",
            "state": "NJ",
            "postal_code": "079453129",
            "telephone_number": "201-704-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 CLINTON ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075221775",
            "telephone_number": "973-790-6594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDOLEON",
        "first_name": "MARY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA06672300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Kirshbaum
• Kittery Dialysis LLC
• Serdal Brian Kocak, DDS
• Jalal Koj, MD
• Monika Komosinski, CRNA
• Mersiha Konjhodzic
• Slawomir M Kosinski, M.D.
• Dimitrios Ioannis Koutsomitis, MD
• Matthew John Kraeutler, MD
• Kaila Krishnamoorthy, M.D.

• Obstetrics & Gynecology Physician in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Obstetrics & Gynecology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.