Elizabeth K Mammen-Prasad, MD

Primary specialty

Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X

License

25MA05474200 Issued in NJ

Practice address

50 Union Ave
Suite# 603
Irvington, NJ 07111-3262

Phone

(973) 399-9250

Fax

(732) 252-6634

NPI assigned

Mar 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Infectious DiseaseAlso: Pediatric Medicine

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Newark Beth Israel Medical Center Hospital, Newark, NJ, CCN 310002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elizabeth.mammenprasad@direct.hackensackmeridian.org
• FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

• Hackensack Meridian Health Medical Group - Complex Care PC

  • Internal Medicine Physician
  • Red Bank, NJ
  • NPI 1154379626
  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249
  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD

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

• Newark Beth Israel Medical Center Inc

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1215027966
  Care Compare affiliation

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366411084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 UNION AVE",
            "address_2": "SUITE#603",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113262",
            "telephone_number": "973-399-9250",
            "fax_number": "732-252-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 UNION AVE",
            "address_2": "SUITE# 603",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113262",
            "telephone_number": "973-399-9250",
            "fax_number": "732-252-6634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMMEN-PRASAD",
        "first_name": "ELIZABETH",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "NJ",
            "license": "25MA05474200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annette Lowe-Larkins
• Eunice E Luke
• Lyons Pharmacy
• Marie Florence Macenat
• Making a Difference in Teens and Young Adults
• Maple Gardens Pharmacy
• Jeannie Martinez-Gonzales, RT(R)
• Harvey G Masor, MD
• Mat/CH Care Service Inc.
• Sandrine Claire Mbouyo, RPH

• Pediatric Infectious Diseases Physician in Irvington, NJ
• Providers in Irvington, NJ by specialty
• Pediatric Infectious Diseases Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.