Individual provider Active NPI

Angela Mukherjee, D.O.

  • Pediatrics Physician
  • Summit, NJ
National Provider Identifier
1164718300
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MB08929500 Issued in NJ
Practice address
33 Overlook Rd
Suite 101
Summit, NJ 07901-3570
Phone
(908) 273-1112
Fax
(908) 273-1146
NPI assigned
Jun 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MB08929500 NJ Primary

Addresses

Primary practice location

33 Overlook Rd
Suite 101
Summit, NJ 07901-3570

Mailing address

33 Overlook Rd
Suite 101
Summit, NJ 07901-3570
Phone (908) 273-1112

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
I20130815000427 NJ Practitioner - Pediatric Medicine 3173765419 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB08929500NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare, LLC Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: angela.mukherjee@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1164718300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 OVERLOOK RD",
            "address_2": "SUITE 101",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013570",
            "telephone_number": "908-273-1112",
            "fax_number": "908-273-1146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 OVERLOOK RD",
            "address_2": "SUITE 101",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013570",
            "telephone_number": "908-273-1112",
            "fax_number": "908-273-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKHERJEE",
        "first_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-27",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MB08929500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

Verify at the official NPI Registry.