Individual provider Active NPI

Michael R. Dara, MD

  • Internal Medicine Physician
  • Pompton Plains, NJ
National Provider Identifier
1356321780
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
43399 Issued in NJ
Practice address
28 Jackson Ave
Pompton Plains, NJ 07444-1453
Phone
(973) 835-2575
Fax
(973) 835-0531
NPI assigned
Jan 20, 2006
Last updated
Sep 12, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 43399 NJ Primary

Addresses

Primary practice location

28 Jackson Ave
Pompton Plains, NJ 07444-1453

Mailing address

28 Jackson Ave
Pompton Plains, NJ 07444-1453
Phone (973) 835-2575

Other identifiers 1

IdentifierTypeStateIssuer
3303306MedicaidNJ

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
I20100914000790 NJ Practitioner - Internal Medicine 6901963420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5596

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43399NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group Internal Medicine CurrentSince Nov 15, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 103
Morristown, NJ 07960
Phone (973) 971-7130

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189555200000",
    "number": "1356321780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 JACKSON AVE",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074441453",
            "telephone_number": "973-835-2575",
            "fax_number": "973-835-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 JACKSON AVE",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074441453",
            "telephone_number": "973-835-2575",
            "fax_number": "973-835-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARA",
        "first_name": "MICHAEL",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2007-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "43399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3303306",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompton Plains, NJ

Sources for this page

Verify at the official NPI Registry.