Individual provider Active NPI

Ninette Marciano Kanarek, MD

  • Pediatrics Physician
  • Teaneck, NJ
National Provider Identifier
1295876514
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA07449500 Issued in NJ
Practice address
197 Cedar LN
Teaneck, NJ 07666-4317
Phone
(201) 836-7171
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA07449500 NJ Primary

Addresses

Primary practice location

197 Cedar LN
Teaneck, NJ 07666-4317

Mailing address

360 Warwick Ave
Teaneck, NJ 07666-3036
Phone (201) 833-8799

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20180508002067 NY Practitioner - Pediatric Medicine 2961766498 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA07449500NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Refuah Health Center Inc CurrentSince May 1, 2018 Accepting new patients
Refuah Health Center, Inc. CurrentSince May 1, 2018 Accepting new patients
Advocare, LLC Pediatrics Past Accepting new patients

Locations

728 N Main St
New Square, NY 10977
Phone (845) 354-9301

Interoperability endpoints

  • Direct secure messaging: ninette.marcianokanarek@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295876514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 WARWICK AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663036",
            "telephone_number": "201-833-8799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 CEDAR LN",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664317",
            "telephone_number": "201-836-7171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAREK",
        "first_name": "NINETTE",
        "middle_name": "MARCIANO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA07449500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.