Organization Active NPI

Medical Associates of Princeton

  • Internal Medicine Physician
  • Princeton, NJ
National Provider Identifier
1245269166
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA06229500 Issued in NJ
Legal business name
MEDICAL ASSOCIATES OF PRINCETON
Practice address
256 Bunn Dr
Suite 3a
Princeton, NJ 08540-2859
Phone
(609) 683-7773
Fax
(609) 683-7958
NPI assigned
Jul 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Natalia Dashevsky, MD
Title
Medical Director
Phone
(609) 683-7773

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 25MA06229500 NJ Primary

Addresses

Primary practice location

256 Bunn Dr
Suite 3a
Princeton, NJ 08540-2859

Mailing address

256 Bunn Dr
Suite 3a
Princeton, NJ 08540-2859
Phone (609) 683-7773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040825000914 NJ Part B Supplier - Clinic/Group Practice 9032183900 Receives reassigned benefits from 3 practitioners
Practice locations: Princeton, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2023875Medical Associates of Princeton, LLC256 Bunn Dr, Suite 3a, Princeton, NJ 08540Certificate of waiverMay 3, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245269166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 BUNN DR",
            "address_2": "SUITE 3A",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402859",
            "telephone_number": "609-683-7773",
            "fax_number": "609-683-7958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 BUNN DR",
            "address_2": "SUITE 3A",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085402859",
            "telephone_number": "609-683-7773",
            "fax_number": "609-683-7958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF PRINCETON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DASHEVSKY",
        "authorized_official_first_name": "NATALIA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "609-683-7773",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA06229500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.