Individual provider Active NPI

Carmen M Garmendia

  • Internal Medicine Physician
  • Passaic, NJ
National Provider Identifier
1417678798
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
26NJ01334300 Issued in NJ
Practice address
121 Prospect St
Passaic, NJ 07055-4989
Phone
(973) 777-3006
Fax
(973) 777-5587
NPI assigned
Sep 6, 2022
Last updated
Sep 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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 26NJ01334300 NJ Primary

Addresses

Primary practice location

121 Prospect St
Passaic, NJ 07055-4989

Mailing address

121 Prospect St
Passaic, NJ 07055-4989
Phone (973) 777-3006

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221107000358 NJ Practitioner - Nurse Practitioner 0941677827 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roseville Medical Society LLCGroup PAC ID 3072939255, 15 clinicians
North Ward Medical Arts LLCGroup PAC ID 3173946175, 11 clinicians

Practice addresses (Care Compare)

346 Roseville Ave
Newark, NJ 07107-1722
Phone (973) 482-7245

485 Mount Prospect Ave
FL 1
Newark, NJ 07104-2903
Phone (973) 485-6433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ01334300NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Salerno Medical Associates, LLC Single Specialty CurrentSince Sep 14, 2024 Accepting new patients
Call to Care LLC Single Specialty CurrentSince Sep 14, 2024 Accepting new patients
Roseville Medical Society LLC Single Specialty CurrentSince Sep 14, 2024 Accepting new patients
Diligent Medical Care PC Single Specialty CurrentSince Oct 1, 2022 Accepting new patients
North Ward Medical Arts LLC Single Specialty CurrentSince Sep 14, 2024 Accepting new patients
Senior Healthcare Outreach Program Single Specialty CurrentSince Sep 14, 2024 Accepting new patients
Metropolitan Medical Group LLC Single Specialty CurrentSince Sep 14, 2024 Accepting new patients
Medical & Surgical Family Practice of Passaic P a Single Specialty PastSince Sep 11, 2022 Accepting new patients

Locations

613 Park Ave
East Orange, NJ 07017
Phone (973) 672-2455

613 Park Ave
Fl 1
East Orange, NJ 07017
Phone (973) 556-0955

613 Park Ave
Fl 2
East Orange, NJ 07017
Phone (973) 485-6433

346 Roseville Ave
Newark, NJ 07107
Phone (973) 482-7245

485 Mount Prospect Ave
Fl 1
Newark, NJ 07104
Phone (973) 485-6433

523 Park Ave
Orange, NJ 07050
Phone (862) 229-1516

570 32nd St
Union City, NJ 07087
Phone (201) 758-7250

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13207/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/DBACCA

Organizations & group practices 8

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": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1417678798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 PROSPECT ST",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070554989",
            "telephone_number": "973-777-3006",
            "fax_number": "973-777-5587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 PROSPECT ST",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070554989",
            "telephone_number": "973-777-3006",
            "fax_number": "973-777-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARMENDIA",
        "first_name": "CARMEN",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "26NJ01334300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

Verify at the official NPI Registry.