Individual provider Active NPI

Mohamed A Esiely, M.D.

  • Obstetrics & Gynecology Physician
  • Hoboken, NJ
National Provider Identifier
1083942635
Registry record updated Jul 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25MA08667800 Issued in NJ
Practice address
79 Hudson St Ste 204
Hoboken, NJ 07030-5641
Phone
(201) 222-5451
NPI assigned
Nov 19, 2009
Last updated
Jul 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 25MA08667800 NJ Primary

Addresses

Primary practice location

79 Hudson St Ste 204
Hoboken, NJ 07030-5641

Mailing address

79 Hudson St Ste 204
Hoboken, NJ 07030-5641
Phone (201) 222-5451

Other identifiers 1

IdentifierTypeStateIssuer
0227854MedicaidNJ

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
I20100807000063 NJ Practitioner - Obstetrics/Gynecology 6204969504 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

79 Hudson St
Suite 204
Hoboken, NJ 07030-5641
Phone (201) 222-5451

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08667800NJMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Wise Women Obstetrics & Gynecology CurrentSince Jul 15, 2010 Accepting new patients
Central Avenue Professional Services, PC Past Accepting new patients
Jersey City Medical Center Past Accepting new patients

Locations

79 Hudson St
Ste 204
Hoboken, NJ 07030
Phone (201) 222-5451

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14716/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mohamed.esiely.1@14716.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688774400000",
    "number": "1083942635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 HUDSON ST STE 204",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305641",
            "telephone_number": "201-222-5451",
            "fax_number": "201-604-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 HUDSON ST STE 204",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305641",
            "telephone_number": "201-222-5451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESIELY",
        "first_name": "MOHAMED",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-19",
        "last_updated": "2023-07-08",
        "certification_date": "2023-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NJ",
            "license": "25MA08667800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0227854",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

Verify at the official NPI Registry.