Mary T. Mitskavich, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MA63523 Issued in NJ

Practice address

3700 Route 33
Suite 101
Neptune, NJ 07753

Phone

(732) 280-7855

Fax

(732) 280-7815

NPI assigned

Jun 10, 2005

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Coastal Ear Nose and Throat, LLC

  • Otolaryngology Physician
  • Neptune, NJ
  • NPI 1861592867
  NPD
• Coastal Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Neptune, NJ
  • NPI 1316219470
  NPD (past)

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327881600000",
    "number": "1457355117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 ROUTE 33",
            "address_2": "SUITE 101",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-280-7855",
            "fax_number": "732-280-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 ROUTE 33",
            "address_2": "SUITE 101",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-280-7855",
            "fax_number": "732-280-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITSKAVICH",
        "first_name": "MARY",
        "middle_name": "T.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-10",
        "last_updated": "2012-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": "MA63523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Danielle Misbah, PA-C
• Sanskriti Mishra, M.D.
• Nidhi Mistry, DO
• Eleni Mitoulis
• Filip Mitreski, MD
• Storm G Moeller, MD
• Sabyasachi Mohapatra, M.D.
• Robert Bruce Mohn Jr.
• Ahmed A Mohsen, M.D.
• Gregg Edward Mojares, D.O.

• Otolaryngology Physician in Neptune, NJ
• Providers in Neptune, NJ by specialty
• Otolaryngology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.