Mariette Dermendjian, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

MA60095 Issued in NJ

Practice address

201 Lyons Ave
Newark, NJ 07112-2027

Phone

(973) 926-7203

NPI assigned

Jul 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdermendjian229320@epicdirect.rwjbh.org

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.

• Barnabas Health Medical Group PC

  • Specialist
  • Elizabeth, NJ
  • NPI 1841557246
  Medicare reassignment NPD
• Barnabas Health Medical Group PC

  • Durable Medical Equipment & Medical Supplies
  • Hackensack, NJ
  • NPI 1316772668
  NPD
• Newark Beth Israel Medical Center Inc

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1215027966
  NPD (past)
• Trinitas Regional Medical Center

  • General Acute Care Hospital
  • Elizabeth, NJ
  • NPI 1770583999
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194745968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 W SADDLE RIVER RD",
            "city": "HO HO KUS",
            "state": "NJ",
            "postal_code": "074231644",
            "telephone_number": "201-689-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LYONS AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071122027",
            "telephone_number": "973-926-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERMENDJIAN",
        "first_name": "MARIETTE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NJ",
            "license": "MA60095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental Kidz, Limited Liability Company
• Sarah Suzanne Deol, MD
• Nishitha Reddy Depa, M.D.
• David A. Depaolis, D.C.
• Ariane Monique Chua Dequina, MSN, RN, NP-C, CMSRN
• Jagrut Desai
• Karishma Desai, MD
• Nirav Desai, PHARMD
• Nishu Desai, DPM
• Pooja Desai

• Neonatal-Perinatal Medicine Physician in Newark, NJ
• Providers in Newark, NJ by specialty
• Neonatal-Perinatal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.