Individual provider Active NPI

Erenio Mejias, M.D.

  • Internal Medicine Physician
  • Elizabeth, NJ
National Provider Identifier
1376603118
Registry record updated Jul 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA03870300 Issued in NJ
Practice address
505 Westfield Ave
Elizabeth, NJ 07208-1622
Phone
(908) 354-5461
Fax
(908) 354-5462
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2012

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 25MA03870300 NJ Primary

Addresses

Primary practice location

505 Westfield Ave
Elizabeth, NJ 07208-1622

Mailing address

505 Westfield Ave
Elizabeth, NJ 07208-1622
Phone (908) 354-5461

Other identifiers 6

IdentifierTypeStateIssuer
01000082600OtherNJAMERICHOICE
0935662003OtherCIGNA
2598273OtherNYGHI
F02912OtherHEALTHNET
1033890OtherNJHORIZON BC BS OF NJ
1611101MedicaidNJ

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
I20111219000736 NJ Practitioner - Internal Medicine 5597930644 Practice locations: Elizabeth, NJ

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

505 Westfield Ave
Elizabeth, NJ 07208-1622
Phone (908) 354-5461

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03870300NJMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343347200000",
    "number": "1376603118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 WESTFIELD AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081622",
            "telephone_number": "908-354-5461",
            "fax_number": "908-354-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 WESTFIELD AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081622",
            "telephone_number": "908-354-5461",
            "fax_number": "908-354-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEJIAS",
        "first_name": "ERENIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2012-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA03870300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "01000082600",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0935662003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "2598273",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "F02912",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BC BS OF NJ",
            "identifier": "1033890",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1611101",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.