Individual provider Active NPI

Mary Elias

  • Gerontology Nurse Practitioner
  • Newark, NJ
National Provider Identifier
1265992416
Registry record updated Mar 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
26NR13849900 Issued in NJ
Practice address
140 Bergen St
Newark, NJ 07103-2425
Phone
(973) 972-2479
NPI assigned
Mar 22, 2019
Last updated
Mar 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 26NR13849900 NJ Primary

Addresses

Primary practice location

140 Bergen St
Newark, NJ 07103-2425

Mailing address

140 Bergen St
Newark, NJ 07103-2425

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
I20190829002008 NJ Practitioner - Nurse Practitioner 0143558049 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HDC Care Solutions LLCGroup PAC ID 0345634770, 190 clinicians
Value Based Long Term Care H PCGroup PAC ID 4587104641, 145 clinicians

Practice addresses (Care Compare)

103 Carnegie Ctr
Suite 300
Princeton, NJ 08540-6235
Phone (888) 964-6681

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR13849900NJMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HDC Care Solutions, LLC Gerontology CurrentSince Sep 22, 2022 Accepting new patients
Value Based Long Term Care H PC CurrentSince May 10, 2025 Accepting new patients
Vitalpoint Healthpc CurrentSince Aug 9, 2025 Accepting new patients
Healthdrive Medical Services Southeast LLC Gerontology CurrentSince Aug 1, 2025 Accepting new patients
Medical Director Services PC CurrentSince Jul 4, 2025 Accepting new patients
The Heart Center of the Oranges Past Accepting new patients

Locations

43 N White Horse Pike
Hammonton, NJ 08037
Phone (609) 567-3100

103 Carnegie Ctr
Ste 300
Princeton, NJ 08540
Phone (609) 524-2514

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1265992416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032425",
            "telephone_number": "973-972-2479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIAS",
        "first_name": "MARY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NJ",
            "license": "26NR13849900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.