Individual provider Active NPI

Consetta Mae Cheatam, MD

  • Specialist
  • Rutherford, NJ
National Provider Identifier
1619989860
Registry record updated Jun 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA070577 Issued in NJ
Practice address
22 Sylvan St Ste 300
Rutherford, NJ 07070-2069
Phone
(201) 438-8860
Fax
(201) 438-1994
NPI assigned
Aug 13, 2006
Last updated
Jun 25, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA070577 NJ Primary

Addresses

Primary practice location

22 Sylvan St Ste 300
Rutherford, NJ 07070-2069

Mailing address

22 Sylvan St Ste 300
Rutherford, NJ 07070-2087
Phone (201) 438-8860

Other identifiers 1

IdentifierTypeStateIssuer
8271500MedicaidNJ

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
I20100128000410 NJ Practitioner - Obstetrics/Gynecology 5193799203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Rutgers New Jersey Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22 Sylvan St
Suite 300
Rutherford, NJ 07070-2087
Phone (201) 438-8860

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA070577NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Humc Opco LLC Current Accepting new patients
Specializing in Women's Care LLC Specialist CurrentSince Jan 19, 2010 Accepting new patients
Garden State Healthcare Associates, LLC CurrentSince Aug 25, 2022 Accepting new patients
Specialized in Womens Care, LLC Specialist PastSince Oct 1, 2001 Accepting new patients
Women and Children Primary Care of Passaic Past Accepting new patients

Locations

308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574

17 Sylvan St
Ste 201
Rutherford, NJ 07070
Phone (201) 438-0539

22 Sylvan St
Ste 300
Rutherford, NJ 07070
Phone (201) 438-8860

55 Meadowlands Pkwy
Secaucus, NJ 07094
Phone (201) 325-6744

Interoperability endpoints

  • Direct secure messaging: ccheatam@direct.hobokenumc.md
  • Direct secure messaging: ccheatam208246@ahs.direct-ci.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1619989860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 SYLVAN ST STE 300",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070702087",
            "telephone_number": "201-438-8860",
            "fax_number": "201-438-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 SYLVAN ST STE 300",
            "city": "RUTHERFORD",
            "state": "NJ",
            "postal_code": "070702069",
            "telephone_number": "201-438-8860",
            "fax_number": "201-438-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEATAM",
        "first_name": "CONSETTA",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA070577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8271500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rutherford, NJ

Sources for this page

Verify at the official NPI Registry.