Active NPI
Ivan R Pierra, ATC
- Sports Medicine (Preventive Medicine) Physician
- Whippany, NJ
National Provider Identifier
1457941999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Preventive Medicine) Physician
- License
- 25MT00277600
- Practice address
- 24 Melanie LN
Whippany, NJ 07981-1637 - Phone
- (562) 505-7598
- NPI assigned
- Jan 19, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Preventive Medicine) Physician | 2083S0010X | 25MT00277600 | NJ | Primary |
Addresses
Primary practice location
24 Melanie LN
Whippany, NJ 07981-1637
Mailing address
24 Melanie LN
Whippany, NJ 07981-1637
Phone (562) 505-7598
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MT00277600 | NJ | MD | Sports Medicine (Preventive Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611014400000",
"number": "1457941999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 MELANIE LN",
"city": "WHIPPANY",
"state": "NJ",
"postal_code": "079811637",
"telephone_number": "562-505-7598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 MELANIE LN",
"city": "WHIPPANY",
"state": "NJ",
"postal_code": "079811637",
"telephone_number": "562-505-7598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIERRA",
"first_name": "IVAN",
"middle_name": "R",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-01-19",
"last_updated": "2021-01-19",
"certification_date": "2021-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "2083S0010X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Preventive Medicine, Sports Medicine",
"state": "NJ",
"license": "25MT00277600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whippany, NJ
- Punitkumar B Patel
- Srujal Patel, PHARM.D.
- Path to Healing Counseling Services
- Robert Mark Perkins, MD, MPH
- Pharmtastic Pharmacy Inc (Pharmtastic Pharmacy)
- Erika Pietzsch, LPC
- Kimberly Helen Polimeni, PT
- Vienna-Marie Prato
- Premise Health of New Jersey Medical PC (Barclays Health Center at Whippany)
- Primary Care Partners LLC (Franklin Pediatrics)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.