Mirmanesh Medicine

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

MIRMANESH MEDICINE

Practice address

100 Route 73
Voorhees, NJ 08043-9575

Phone

(609) 753-7374

NPI assigned

Dec 11, 2017

Organization subpart

No

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

Authorized official

Name

Dr. John Mirmanesh, MD

Title

Medical Director

Phone

(609) 980-5672

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shahram Jay Mirmanesh, MD, MBA

  • Pediatrics Physician
  • Marlton, NJ
  • NPI 1750335360
  Medicare reassignment NPD

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1346755402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ROUTE 73",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439575",
            "telephone_number": "856-753-7374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ROUTE 73",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439575",
            "telephone_number": "609-753-7374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "651 Route 73 N",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080533444",
            "country_code": "US",
            "telephone_number": "856-985-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIRMANESH MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-11",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "MIRMANESH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "609-980-5672",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Minore
• Mark Mintz, MD
• Randy T Mintz, MD
• Patricia Miracle-Botley
• Pushpa P Mirchandani, M.D.
• Shraddha Mittal, MD
• Mobile Urgent Care Medical Services PC
• Alisa Benson Modena, M.D.
• Modern Intervention Strategies
• Modern Intervention Strategies

• Pediatrics Physician in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.