Individual provider Active NPI

Michael Seth Owitz, MD

  • Adult Medicine Physician
  • Maplewood, NJ
National Provider Identifier
1477132843
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
25MA12367200 Issued in NJ
Practice address
264 Boyden Ave
Maplewood, NJ 07040-3070
Phone
(973) 761-5200
NPI assigned
Apr 5, 2021
Last updated
Aug 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 25MA12367200 NJ Primary

Addresses

Primary practice location

264 Boyden Ave
Maplewood, NJ 07040-3070

Mailing address

264 Boyden Ave
Maplewood, NJ 07040-3070
Phone (973) 761-5200

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
I20240917005001 NJ Practitioner - Family Practice 5496296477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Buffalo School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

506 Broadway
Bayonne, NJ 07002-3712
Phone (201) 471-7012

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care of New Jersey PC CurrentSince Sep 1, 2024 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Sep 1, 2024 Accepting new patients
Riverside Medical Group Past 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

264 Boyden Ave
Maplewood, NJ 07040
Phone (973) 761-0764

Interoperability endpoints

  • Direct secure messaging: mowitz129086@direct.optum.com

Organizations & group practices 4

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": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1477132843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 BOYDEN AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403070",
            "telephone_number": "973-761-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 BOYDEN AVE",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403070",
            "telephone_number": "973-761-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWITZ",
        "first_name": "MICHAEL",
        "middle_name": "SETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-05",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NJ",
            "license": "25MA12367200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, NJ

Sources for this page

Verify at the official NPI Registry.