Individual provider Active NPI

Irene Mamkin, M.D.

  • Pediatric Endocrinology Physician
  • West Orange, NJ
National Provider Identifier
1326210485
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
250979 Issued in NY
Practice address
375 Mount Pleasant Ave
West Orange, NJ 07052-2724
Phone
(973) 322-6900
Fax
(973) 322-6999
NPI assigned
Mar 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 250979 NY
Pediatric Endocrinology Physician 2080P0205X 250979 NY Primary

Addresses

Primary practice location

375 Mount Pleasant Ave
West Orange, NJ 07052-2724

Mailing address

375 Mount Pleasant Ave
West Orange, NJ 07052-2724
Phone (973) 322-6900

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110531000661 NJ Practitioner - Pediatric MedicinePractitioner - Endocrinology 4789861725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
250979NYMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Feb 1, 2013 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Feb 1, 2013 Accepting new patients

Locations

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

235 Millburn Ave
Ste 101
Millburn, NJ 07041
Phone (973) 376-8034

375 Mount Pleasant Ave
Ste 105
West Orange, NJ 07052
Phone (973) 322-6900

375 Mount Pleasant Ave
West Orange, NJ 07052
Phone (973) 322-6900

Interoperability endpoints

  • Direct secure messaging: imamkin49256@epicdirect.rwjbh.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1206748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1326210485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 MOUNT PLEASANT AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522724",
            "telephone_number": "973-322-6900",
            "fax_number": "973-322-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 MOUNT PLEASANT AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522724",
            "telephone_number": "973-322-6900",
            "fax_number": "973-322-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMKIN",
        "first_name": "IRENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-29",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "250979",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NY",
            "license": "250979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.