Individual provider Active NPI

Mitchell Ferges

  • Specialist
  • Somerset, NJ
National Provider Identifier
1407853310
Registry record updated Jul 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MA03204300 Issued in NJ
Practice address
33 Clyde Rd
Suite 102
Somerset, NJ 08873-5032
Phone
(732) 873-9200
Fax
(732) 873-1699
NPI assigned
Jul 7, 2005
Last updated
Jul 26, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MA03204300 NJ Primary

Addresses

Primary practice location

33 Clyde Rd
Suite 102
Somerset, NJ 08873-5032

Mailing address

33 Clyde Rd
Suite 102
Somerset, NJ 08873-5032
Phone (732) 873-9200

Other identifiers 11

IdentifierTypeStateIssuer
TS058OtherNJOXFORD #
2243283OtherNJAETNA HMO #
4V5041OtherNJEMPIRE BC/BS E. BRUNS. #
40A653OtherNJEMPIRE BC/BS SOMERSET #
2499585OtherNJGHI PPO #
0K3007OtherNJHEALTHNET #
4093715OtherNJAETNA PPO #
110083490OtherNJRAILROAD MDCR #
15235OtherNJAMERICAID #
0099027000OtherNJAMERIHEALTH #
1175203MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA03204300NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
RWJ Endosurgical Center LLC PastSince Nov 2, 2000 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1407853310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 CLYDE RD",
            "address_2": "SUITE 102",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088735032",
            "telephone_number": "732-873-9200",
            "fax_number": "732-873-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 CLYDE RD",
            "address_2": "SUITE 102",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088735032",
            "telephone_number": "732-873-9200",
            "fax_number": "732-873-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGES",
        "first_name": "MITCHELL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA03204300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD #",
            "identifier": "TS058",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO #",
            "identifier": "2243283",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS E. BRUNS. #",
            "identifier": "4V5041",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS SOMERSET #",
            "identifier": "40A653",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PPO #",
            "identifier": "2499585",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET #",
            "identifier": "0K3007",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO #",
            "identifier": "4093715",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MDCR #",
            "identifier": "110083490",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAID #",
            "identifier": "15235",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH #",
            "identifier": "0099027000",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1175203",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.