Active NPI
Alfred L Mauro, MD
- Pain Medicine Physician
- Jersey City, NJ
National Provider Identifier
1255374062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine Physician
- License
- 25MA02182900
- Practice address
- 590 Newark Ave
Jersey City, NJ 07306 - Phone
- (201) 222-1400
- Fax
- (201) 342-1259
- NPI assigned
- Jun 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 25MA02182900 | NJ | |
| Pain Medicine Physician | 208VP0000X | 25MA02182900 | NJ | Primary |
| Anesthesiology Physician | 207L00000X | 25MA02182900 | NJ |
Addresses
Primary practice location
590 Newark Ave
Jersey City, NJ 07306
Mailing address
PO Box 135
Oradell, NJ 07649
Phone (201) 342-1205
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0965308 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Practitioners of Northern New Jersey Inc | Specialist | Past | Accepting new patients |
| Boro Medical, P.C. | Past | Accepting new patients |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353888000000",
"number": "1255374062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 135",
"city": "ORADELL",
"state": "NJ",
"postal_code": "07649",
"telephone_number": "201-342-1205",
"fax_number": "201-342-1259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 NEWARK AVE",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "07306",
"telephone_number": "201-222-1400",
"fax_number": "201-342-1259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAURO",
"first_name": "ALFRED",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2012-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "25MA02182900",
"primary": false
},
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "NJ",
"license": "25MA02182900",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NJ",
"license": "25MA02182900",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0965308",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.