Individual provider Active NPI

Nicholas C Maglaras, MD

  • Internal Medicine Physician
  • Roselle Park, NJ
National Provider Identifier
1336245109
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA05793700 Issued in NJ
Practice address
236 E Westfield Ave
Roselle Park, NJ 07204
Phone
(908) 245-8222
Fax
(908) 245-6504
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MA57937 NJ
Internal Medicine Physician 207R00000X 25MA05793700 NJ Primary

Addresses

Primary practice location

236 E Westfield Ave
Roselle Park, NJ 07204

Mailing address

236 E Westfield Ave
Roselle Park, NJ 07204-2084
Phone (908) 245-8222

Other identifiers 1

IdentifierTypeStateIssuer
6125107MedicaidNJ

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
I20040129000759 NJ Practitioner - Internal MedicinePractitioner - Pulmonary Disease 2466355292 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pulmonary Disease
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nicholas C Maglaras MD LLPGroup PAC ID 3678476405, 2 clinicians

Practice addresses (Care Compare)

236 E Westfield Ave
Suite 5
Roselle Park, NJ 07204-2084
Phone (908) 245-8222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05793700NJMDInternal Medicine Physician
MA57937NJMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fellowship Village Inc. CurrentSince Feb 1, 2023 Accepting new patients
Fellowship Senior Living, Inc. CurrentSince Feb 1, 2023 Accepting new patients
Nicholas C Maglaras MD LLP Pulmonary Disease CurrentSince Jan 1, 1998 Accepting new patients

Locations

8000 Fellowship Rd
Basking Ridge, NJ 07920
Phone (908) 580-3800

236 E Westfield Ave
Ste 5
Roselle Park, NJ 07204
Phone (908) 245-8222

236 E Westfield Ave
Roselle Park, NJ 07204
Phone (908) 245-8222

236 E Westfield Ave
Ste 203
Roselle Park, NJ 07204
Phone (908) 662-4949

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19916/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1336245109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 E WESTFIELD AVE",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "072042084",
            "telephone_number": "908-245-8222",
            "fax_number": "908-245-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "236 E WESTFIELD AVE",
            "city": "ROSELLE PARK",
            "state": "NJ",
            "postal_code": "07204",
            "telephone_number": "908-245-8222",
            "fax_number": "908-245-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGLARAS",
        "first_name": "NICHOLAS",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NJ",
            "license": "MA57937",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA05793700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6125107",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roselle Park, NJ

Sources for this page

Verify at the official NPI Registry.