Organization Active NPI

Edgar R. Mejia MD PA

  • Pediatrics Physician
  • Paterson, NJ
National Provider Identifier
1265489116
Registry record updated Nov 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MA059882 Issued in NJ
Legal business name
EDGAR R. MEJIA MD PA
Practice address
760 Market St
Paterson, NJ 07513-1241
Phone
(973) 523-8083
Fax
(973) 523-1133
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2013

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

Authorized official

Name
Dr. Edgar R Mejia, MDNPI 1780645374
Title
President
Phone
(973) 523-8083

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X MA059882 NJ Primary

Addresses

Primary practice location

760 Market St
Paterson, NJ 07513-1241

Mailing address

760 Market St
Paterson, NJ 07513-1241
Phone (973) 523-8083

Other identifiers 1

IdentifierTypeStateIssuer
6257402MedicaidNJ

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
31D1036077Edgar R Mejia MD760 Market St, Paterson, NJ 07513Certificate of waiverJan 19, 2027

National Provider Directory

National Provider Directory

Locations

760 Market St
Paterson, NJ 07513
Phone (973) 523-8083

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": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384732800000",
    "number": "1265489116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 MARKET ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075131241",
            "telephone_number": "973-523-8083",
            "fax_number": "973-523-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 MARKET ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075131241",
            "telephone_number": "973-523-8083",
            "fax_number": "973-523-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGAR R. MEJIA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2013-11-18",
        "status": "A",
        "authorized_official_last_name": "MEJIA",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-523-8083",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA059882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6257402",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.