Alisa Margaret Ghanaim, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00727000 Issued in NJ

Practice address

1005 N Washington Ave
Green Brook, NJ 08812-2698

Phone

(732) 968-8900

NPI assigned

Aug 18, 2022

Last updated

Aug 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medemerge LLCGroup PAC ID 1456340595, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Medemerge LLC

  dba Medemerge Medical Associates, PA

  • Primary Care Clinic/Center
  • Green Brook, NJ
  • NPI 1366656431
  Medicare reassignment Care Compare group
• Medemerge P.a.

  • Family Medicine Physician
  • Green Brook, NJ
  • NPI 1184643132
  NPD

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1457079139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 PERRINE RD",
            "city": "MARTINSVILLE",
            "state": "NJ",
            "postal_code": "088362305",
            "telephone_number": "732-397-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 N WASHINGTON AVE",
            "city": "GREEN BROOK",
            "state": "NJ",
            "postal_code": "088122698",
            "telephone_number": "732-968-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHANAIM",
        "first_name": "ALISA",
        "middle_name": "MARGARET",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00727000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lester Frankel, OD
• Gall & Casterline PC
• Kevin A. Gall, DC
• Elvira A. Garcia, APN-C
• Get Physical, LLC (Fyzical Therapy & Balance Centers)
• Andrew Godenick
• Green Brook Family Dentalcare LLC
• Green Brook Township Public Schools
• Green Brook Vision Associates Inc (Saft Opticians)
• Greenbrook Dental, LLC

• Physician Assistant in Green Brook, NJ
• Providers in Green Brook, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.

Verify at the official NPI Registry.