Active NPI
Miriam Enock
- Physician Assistant
- Newark, NJ
National Provider Identifier
1447621909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 25MP00368500
- Practice address
- 205 S Orange Ave
Suite a-1020
Newark, NJ 07103-2785 - Phone
- (973) 972-3066
- NPI assigned
- Oct 9, 2015
- Last updated
- Feb 15, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00368500 | NJ | Primary |
| Medical Physician Assistant | 363AM0700X | 25MP00368500 | NJ | |
| Surgical Physician Assistant | 363AS0400X | 25MP00368500 | NJ |
Addresses
Primary practice location
205 S Orange Ave
Suite a-1020
Newark, NJ 07103-2785
Mailing address
205 S Orange Ave
Suite a-1020
Newark, NJ 07103-2785
Phone (973) 972-3066
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
228 Franklin Ave
Nutley, NJ 07110-4700
Phone (973) 542-2447
506 Broadway
Bayonne, NJ 07002-3712
Phone (201) 471-7012
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.15 of 100
- Quality
- 71.59
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.65
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Medical Care of New Jersey PC | Current | Accepting new patients | |
| Everyday Medical Care PC | Current | Accepting new patients | |
| Optum Medical Care of New Jersey PC | Current | Accepting new patients | |
| A.G. Dikengil, MD, PA | Past | Accepting new patients |
Locations
935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012
Interoperability endpoints
- menock76818@direct.optum.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Durable Medical Equipment & Medical Supplies
- Belleville, NJ
- NPI 1255050902
-
- Radiology Clinic/Center
- Lyndhurst, NJ
- NPI 1205992690
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613347200000",
"number": "1447621909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 S ORANGE AVE",
"address_2": "SUITE A-1020",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071032785",
"telephone_number": "973-972-3066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 S ORANGE AVE",
"address_2": "SUITE A-1020",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071032785",
"telephone_number": "973-972-3066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENOCK",
"first_name": "MIRIAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-09",
"last_updated": "2021-02-15",
"certification_date": "2021-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00368500",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NJ",
"license": "25MP00368500",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NJ",
"license": "25MP00368500",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.