Individual provider Active NPI

Meera Wells, MD

  • Child & Adolescent Psychiatry Physician
  • Easton, MD
National Provider Identifier
1407952302
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
D0063478 Issued in MD
Practice address
210 Marlboro Ave # 394
Easton, MD 21601-2765
Phone
(443) 256-3818
Fax
(443) 252-8084
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X D0063478 MD Primary

Addresses

Primary practice location

210 Marlboro Ave # 394
Easton, MD 21601-2765

Mailing address

19 Davis Ave
FL 9
Neptune, NJ 07753-4488
Phone (443) 256-3818

Other practice location 1

8865 Glebe Park Dr Unit 1
Easton, MD 21601-7069
Phone (410) 822-4619

Other identifiers 1

IdentifierTypeStateIssuer
083939600MedicaidMD

Other names 1

  • Dr. Meera Kodiyan Other name

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
I20041209000936 NJ Practitioner - Psychiatry 3971569062 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0063478MDMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Complex Care PC CurrentSince Sep 30, 2019 Accepting new patients
Marshy Hope Family Services, LLC Child & Adolescent Psychiatry PastSince Aug 20, 2002 Accepting new patients
For All Seasons, Inc. Past Accepting new patients
Barnabas Health Medical Group, PC PastSince Jan 15, 2007 Accepting new patients

Locations

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

19 Davis Ave
Fl 9
Neptune, NJ 07753
Phone (732) 897-3640

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

Interoperability endpoints

  • Direct secure messaging: meera.wells@direct.hackensackmeridian.org

Organizations & group practices 4

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1407952302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 DAVIS AVE",
            "address_2": "FL 9",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534488",
            "telephone_number": "443-256-3818",
            "fax_number": "443-252-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MARLBORO AVE # 394",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216012765",
            "telephone_number": "443-256-3818",
            "fax_number": "443-252-8084"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8865 Glebe Park Dr Unit 1",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "MD",
            "postal_code": "216017069",
            "country_code": "US",
            "telephone_number": "410-822-4619",
            "fax_number": "410-822-0984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLS",
        "first_name": "MEERA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D0063478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083939600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEERA",
            "last_name": "KODIYAN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Easton, MD

Sources for this page

Verify at the official NPI Registry.