Individual provider Active NPI

Nawras Makhsida, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Randolph, NJ
National Provider Identifier
1154523959
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
25MA11801900 Issued in NJ
Practice address
715 Route 10
Randolph, NJ 07869-2025
Phone
(973) 343-7040
Fax
(973) 718-4881
NPI assigned
Jun 4, 2007
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 25MA11801900 NJ Primary

Addresses

Primary practice location

715 Route 10
Randolph, NJ 07869-2025

Mailing address

715 Route 10
Randolph, NJ 07869-2025
Phone (973) 343-7040

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
I20230628002935 NJ Practitioner - Endocrinology 8426182197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Health Associates LLCGroup PAC ID 0840283008, 45 clinicians

Practice addresses (Care Compare)

123 Newton Sparta Rd
Newton, NJ 07860-2769
Phone (973) 579-6300

532 Lafayette Rd
Sparta, NJ 07871-4411

715 Route 10 E
Randolph, NJ 07869-2025
Phone (973) 343-7040

89 Sparta Ave
Suite 100
Sparta, NJ 07871-1790
Phone (973) 729-2121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11801900NJMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Associates LLC Endocrinology, Diabetes & Metabolism CurrentSince Aug 1, 2023 Accepting new patients
Premier Health Associates, LLC CurrentSince Aug 1, 2023 Accepting new patients
Jefferson Physician Network, LLC Past Accepting new patients

Locations

225 State Rt 23 S
Ste 1C
Hamburg, NJ 07419
Phone (973) 209-1550

123 Newton Sparta Rd
Newton, NJ 07860
Phone (973) 579-1000

715 State Route 10
Randolph, NJ 07869
Phone (973) 343-7040

532 Lafayette Rd
Ste 300
Sparta, NJ 07871
Phone (973) 940-0423

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDJHBA

Organizations & group practices 3

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 4

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": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1154523959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 ROUTE 10",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692025",
            "telephone_number": "973-343-7040",
            "fax_number": "973-718-4881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 ROUTE 10",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692025",
            "telephone_number": "973-343-7040",
            "fax_number": "973-718-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKHSIDA",
        "first_name": "NAWRAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA11801900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randolph, NJ

Sources for this page

Verify at the official NPI Registry.