NPIMap

Individual provider Active NPI

Smita Mahendrakar, MD

  • Nephrology Physician
  • Newark, NJ
National Provider Identifier
1083874580
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA08321100 Issued in NJ
Practice address
185 S Orange Ave
MSB I- 524
Newark, NJ 07103-2757
Phone
(973) 972-4100
NPI assigned
Jun 10, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA08321100 NJ
Nephrology Physician 207RN0300X 25MA08321100 NJ Primary

Addresses

Primary practice location

185 S Orange Ave
MSB I- 524
Newark, NJ 07103-2757

Mailing address

185 S Orange Ave
MSB I-524
Newark, NJ 07103-2757
Phone (973) 972-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081107000776 NJ Practitioner - NephrologyPractitioner - Internal Medicine 5698834497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physician Associates of New Jersey IncGroup PAC ID 9830003417, 374 clinicians

Practice addresses (Care Compare)

140 Bergen St
Newark, NJ 07103-2425
Phone (973) 972-9000

Hospital & facility affiliations

  • FMC Newark University Dialysis facility, Newark, NJ, CCN 312505
  • FMC East Orange Dialysis facility, East Orange, NJ, CCN 312568
  • The University Hospital Hospital, Newark, NJ, CCN 310119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08321100NJMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc Internal Medicine CurrentSince Oct 19, 2015 Accepting new patients

Locations

30 Bergen St
Rm 1205
Newark, NJ 07107
Phone (973) 972-0037

90 Bergen St
Newark, NJ 07103
Phone (973) 972-0037

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

140 Bergen St
Newark, NJ 07103
Phone (973) 972-0320

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 3

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": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1083874580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 S ORANGE AVE",
            "address_2": "MSB I-524",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032757",
            "telephone_number": "973-972-4100",
            "fax_number": "973-972-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 S ORANGE AVE",
            "address_2": "MSB I- 524",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032757",
            "telephone_number": "973-972-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHENDRAKAR",
        "first_name": "SMITA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08321100",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA08321100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.