Individual provider Active NPI

John R Demais, MD

  • Anesthesiology Physician
  • Millburn, NJ
National Provider Identifier
1558320564
Registry record updated Dec 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA40996 Issued in NJ
Practice address
187 Millburn Avenue
Millburn, NJ 07041
Phone
(973) 467-1466
Fax
(973) 467-1422
NPI assigned
Mar 20, 2006
Last updated
Dec 11, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2009

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 25MA40996 NJ Primary

Addresses

Primary practice location

187 Millburn Avenue
Millburn, NJ 07041

Mailing address

187 Millburn Ave
Millburn, NJ 07041-1847
Phone (973) 467-1466

Other identifiers 1

IdentifierTypeStateIssuer
183231MedicaidNJ

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA40996NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Surgery Center, LLC Past Accepting new patients
Atlantic Coast Gastroenterology Associates Past Accepting new patients
MPV New Jersey MD Services PC Past Accepting new patients
Westwood Anesthesia Associates, P.a. Anesthesiology Past Accepting new patients

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260489600000",
    "number": "1558320564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 MILLBURN AVE",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411847",
            "telephone_number": "973-467-1466",
            "fax_number": "973-467-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 MILLBURN AVENUE",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "07041",
            "telephone_number": "973-467-1466",
            "fax_number": "973-467-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMAIS",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2009-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA40996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183231",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millburn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.