Individual provider Active NPI

Mary J. Flores, ANP

  • Adult Health Nurse Practitioner
  • Union, NJ
National Provider Identifier
1174811095
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00319000 Issued in NJ
Practice address
124 Glenwood CT
Union, NJ 07083-6105
Phone
(908) 964-8866
NPI assigned
Jul 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00319000 NJ Primary

Addresses

Primary practice location

124 Glenwood CT
Union, NJ 07083-6105

Mailing address

124 Glenwood CT
Union, NJ 07083-6105
Phone (908) 964-8866

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140730001426 NJ Practitioner - Nurse Practitioner 5890921555 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Center for Digestive Health, LLCGroup PAC ID 7012275530, 2 clinicians

Practice addresses (Care Compare)

534 Ave E
Suite 1a
Bayonne, NJ 07002-3987
Phone (201) 858-8444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00319000NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ijkg Opco LLC Current Accepting new patients
University Hospital CurrentSince Feb 13, 2024 Accepting new patients
University Hospital CurrentSince Feb 13, 2024 Accepting new patients
Hudson Center for Digestive Health LLC CurrentSince Jan 1, 2018 Accepting new patients
Great Health Medical New Jersey PC CurrentSince Oct 5, 2024 Accepting new patients

Locations

534 Avenue E
Ste 1A
Bayonne, NJ 07002
Phone (201) 720-5535

101 Chase Ave
Ste 105
Lakewood, NJ 08701
Phone (212) 201-1252

150 Bergen St
Rm M219
Newark, NJ 07103
Phone (973) 972-1193

407 Willoughby Ave
Brooklyn, NY 11205
Phone (212) 201-1252

Interoperability endpoints

  • FHIR API: https://epicproxy.et0434.epichosted.com/APIProxyPRD/UHNJ/api/FHIR/R4
  • Direct secure messaging: mary.flores@direct.bayonnemedicalcenter.md
  • Direct secure messaging: mary.flores@direct.carepointhealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310428800000",
    "number": "1174811095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 GLENWOOD CT",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070836105",
            "telephone_number": "908-964-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 GLENWOOD CT",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070836105",
            "telephone_number": "908-964-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "MARY",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-12",
        "last_updated": "2011-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00319000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.