Active NPI
Mark Jack Der Mesropian, D.O.
- Anesthesiology Physician
- Long Branch, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 25MB10061600
- Practice address
- 300 2ND Ave
Long Branch, NJ 07740-6303 - Phone
- (732) 222-5200
- NPI assigned
- Sep 1, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 051857 | CT | |
| Anesthesiology Physician | 207L00000X | 25MB10061600 | NJ | Primary |
Addresses
Primary practice location
300 2ND Ave
Long Branch, NJ 07740-6303
Mailing address
300 Ocean Ave N
Apt 2B
Long Branch, NJ 07740-7578
Phone (315) 447-0857
Other practice location 1
150 55th St
Brooklyn, NY 11203-2012
Phone (718) 630-7476
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mdermesropian130646@nyumc.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
300 2ND Ave
Long Branch, NJ 07740-6303
Phone (732) 222-5200
Hospital & facility affiliations
- Monmouth Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 94.87
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MB10061600 | NJ | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North American Partners in Anesthesia of New Jersey LLC | Anesthesiology | Current | Accepting new patients |
| New York University | Anesthesiology | Current | Accepting new patients |
| New York University | Current | Accepting new patients | |
| Rwjbh Observation Associates LLC | Anesthesiology | Current | Accepting new patients |
| New York University | Anesthesiology | Current | Accepting new patients |
Locations
300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200
703 Main St
Paterson, NJ 07503
Phone (973) 754-2240
110 Rehill Ave
Somerville, NJ 08876
Phone (908) 429-5833
1 Hamilton Health Pl
Trenton, NJ 08690
Phone (609) 584-6763
1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796
530 1st Ave
New York, NY 10016
Phone (212) 263-7216
Interoperability endpoints
- mdermesropian130646@nyumc.direct-ci.com
Organizations & group practices 5
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.
-
- Emergency Medicine Physician
- Livingston, NJ
- NPI 1760095806
Anesthesiology
-
- Anesthesiology Physician
- Brick, NJ
- NPI 1548433048
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
-
- Anesthesiology Physician
- Boynton Beach, FL
- NPI 1952392946
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Long Branch, NJ
- NPI 1609983790
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674432000000",
"number": "1124309349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 OCEAN AVE N",
"address_2": "APT 2B",
"city": "LONG BRANCH",
"state": "NJ",
"postal_code": "077407578",
"telephone_number": "315-447-0857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 2ND AVE",
"city": "LONG BRANCH",
"state": "NJ",
"postal_code": "077406303",
"telephone_number": "732-222-5200"
}
],
"practiceLocations": [
{
"address_1": "150 55th St",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112032012",
"country_code": "US",
"telephone_number": "718-630-7476",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DER MESROPIAN",
"first_name": "MARK",
"middle_name": "JACK",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-01",
"last_updated": "2023-01-23",
"certification_date": "2023-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CT",
"license": "051857",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NJ",
"license": "25MB10061600",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mdermesropian130646@nyumc.direct-ci.com",
"affiliation": "N",
"address_1": "150 55th St",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112032012",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Long Branch, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.