Individual provider Active NPI

Tariq M Mian, M.D.

  • Anesthesiology Physician
  • Newark, NJ
National Provider Identifier
1457429227
Registry record updated Oct 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA07374700 Issued in NJ
Practice address
155 Jefferson St
Newark, NJ 07105-1706
Phone
(908) 490-0036
Fax
(908) 490-0067
NPI assigned
Dec 1, 2006
Last updated
Oct 24, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA07374700 NJ Primary

Addresses

Primary practice location

155 Jefferson St
Newark, NJ 07105-1706

Mailing address

PO Box 1923
Bloomfield, NJ 07003-1923
Phone (908) 490-0036

Other identifiers 1

IdentifierTypeStateIssuer
9029109MedicaidNJ

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
I20041101000472 NJ Practitioner - Anesthesiology 3476515537 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07374700NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Humc Opco LLC Current Accepting new patients
Essex Anesthesiolists PA Anesthesiology Past Accepting new patients
Essex Ironbound Anesthesiologist, LLC Anesthesiology Past Accepting new patients
Gramercy Anesthesia Services, PC Anesthesiology PastSince Mar 7, 2011 Accepting new patients
Meadowbrook Medical Associates Anesthesiology Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tariq.mian@direct.hobokenumc.md

Organizations & group practices 6

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193184000000",
    "number": "1457429227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1923",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070031923",
            "telephone_number": "908-490-0036",
            "fax_number": "908-490-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 JEFFERSON ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071051706",
            "telephone_number": "908-490-0036",
            "fax_number": "908-490-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIAN",
        "first_name": "TARIQ",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA07374700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9029109",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.