Organization Active NPI

Mark L Niemiera MD PC

  • Cardiovascular Disease Physician
  • Perth Amboy, NJ
National Provider Identifier
1598869919
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MARK L NIEMIERA MD PC
Practice address
613 Amboy Ave
Suite 104
Perth Amboy, NJ 08861-2577
Phone
(732) 442-1441
Fax
(732) 442-7684
NPI assigned
Sep 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mark Lee Niemiera, MDNPI 1780788109
Title
Owner
Phone
(732) 442-1441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

613 Amboy Ave
Suite 104
Perth Amboy, NJ 08861-2577

Mailing address

613 Amboy Ave
Suite 104
Perth Amboy, NJ 08861-2577
Phone (732) 442-1441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180219000574 NJ Part B Supplier - Clinic/Group Practice 8123389939 Receives reassigned benefits from 1 practitioner
Practice locations: Perth Amboy, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0961329Mark L Niemiera MD PC613 Amboy Avenue, Perth Amboy, NJ 08861Certificate of waiverJun 1, 2027

National Provider Directory

National Provider Directory

Locations

613 Amboy Ave
Perth Amboy, NJ 08861
Phone (732) 442-5552

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598869919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 AMBOY AVE",
            "address_2": "SUITE 104",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088612577",
            "telephone_number": "732-442-1441",
            "fax_number": "732-442-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 AMBOY AVE",
            "address_2": "SUITE 104",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088612577",
            "telephone_number": "732-442-1441",
            "fax_number": "732-442-7684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK L NIEMIERA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NIEMIERA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-442-1441",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.