Individual provider Active NPI

Sue A. Mah, MD

  • Pediatrics Physician
  • Atlantic City, NJ
National Provider Identifier
1386652154
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD068616L Issued in PA
Practice address
1925 Pacific Ave
Atlantic City, NJ 08401-6713
Phone
(609) 345-4000
Fax
(609) 572-8523
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD068616L PA Primary
Pediatrics Physician 208000000X 25MA07097700 NJ

Addresses

Primary practice location

1925 Pacific Ave
Atlantic City, NJ 08401-6713

Mailing address

100 E Penn SQ
9TH Floor North Tower
Philadelphia, PA 19107-3323
Phone (267) 425-9232

Other identifiers 1

IdentifierTypeStateIssuer
0018104710004MedicaidPA

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
I20110127000476 NJ Practitioner - Pediatric Medicine 9537348248 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07097700NJMDPediatrics Physician
MD068616LPAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanticare Physician Group PA CurrentSince Jan 11, 2014 Accepting new patients
Childens Health Care Associates of New Jersey PC CurrentSince Sep 21, 2010 Accepting new patients
Atlanticare Physician Group, PA CurrentSince Jan 11, 2014 Accepting new patients
Children'S Healthcare Associates of New Jersey PC Pediatrics CurrentSince Sep 21, 2010 Accepting new patients
Childrens Health Care Associates of New Jersey PC Pediatrics Current Accepting new patients

Locations

1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

1 Plainsboro Rd
Plainsboro, NJ 08536
Phone (609) 853-7000

707 Alexander Rd
Princeton, NJ 08540
Phone (609) 520-1717

1012 Laurel Oak Rd
Voorhees, NJ 08043
Phone (856) 435-0086

100 Bowman Dr
Voorhees, NJ 08043
Phone (856) 247-3000

100 E Penn Sq
Fl 9
Philadelphia, PA 19107
Phone (267) 425-9232

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1386652154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E PENN SQ",
            "address_2": "9TH FLOOR NORTH TOWER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191073323",
            "telephone_number": "267-425-9232",
            "fax_number": "267-425-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 PACIFIC AVE",
            "city": "ATLANTIC CITY",
            "state": "NJ",
            "postal_code": "084016713",
            "telephone_number": "609-345-4000",
            "fax_number": "609-572-8523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAH",
        "first_name": "SUE",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD068616L",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA07097700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018104710004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic City, NJ

Sources for this page

Verify at the official NPI Registry.