Active NPI
Amanda Mavraj
- Adult Medicine Physician
- Newark, NJ
National Provider Identifier
1306718929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- 26NR20708000
- Practice address
- 65 Bergen St
Newark, NJ 07107-3001 - Phone
- (973) 972-4307
- NPI assigned
- Sep 22, 2025
- Last updated
- Oct 24, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | 26NR20708000 | NJ | Primary |
Addresses
Primary practice location
65 Bergen St
Newark, NJ 07107-3001
Mailing address
65 Bergen St
Newark, NJ 07107-3001
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NR20708000 | NJ | MD | Adult Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761264000000",
"number": "1306718929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 BERGEN ST",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071073001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 BERGEN ST",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071073001",
"telephone_number": "973-972-4307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAVRAJ",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-22",
"last_updated": "2025-10-24",
"certification_date": "2025-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "NJ",
"license": "26NR20708000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
- Ryann Leigh Mattessich, ACNP
- Monica Rene' Matthews, MS, ATC
- Maryna Matys, NP
- Corazon C Maurrasse, MD
- Susan George Mautone, M.D.
- Lauren Mavus, OTR
- Maxcen Housing Society Inc., New Jersey Branch
- David Adrian McCombs Maxey, PHD
- Maxicare Healthcare Services Inc
- Maxmath Tutoring Online, New Jersey Branch Inc. (MaxMath Home Health Care Agency of New Jersey)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.