Consetta Mae Cheatam, MD
Individual provider Active NPI Specialist · Rutherford, NJ
NPI 1619989860 · NPPES record last updated Jun 25, 2013
Key facts
- NPI
- 1619989860
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- MA070577 (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
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 3
Medicare Care Compare profile
- 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
- Hackensack University Medical Center
- St Mary'S General Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100128000410 | NJ | Practitioner - Obstetrics/Gynecology | 5193799203 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA070577 | NJ | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garden State Healthcare Associates, LLC | Current |
Accepting new patients | |
| Specializing in Women'S Care LLC | Specialist | Current |
Accepting new patients |
| Humc Opco LLC | Current | Accepting new patients | |
| Women and Children Primary Care of Passaic | Past | Accepting new patients | |
| Specialized in Womens Care, LLC | Specialist | Past |
Accepting new patients |
Locations
308 Willow Ave
Hoboken, NJ 07030
Phone (201) 418-1574
22 Sylvan St
Ste 300
Rutherford, NJ 07070
Phone (201) 438-8860
17 Sylvan St
Ste 201
Rutherford, NJ 07070
Phone (201) 438-0539
55 Meadowlands Pkwy
Secaucus, NJ 07094
Phone (201) 325-6744
Interoperability endpoints
- ccheatam@direct.hobokenumc.md
- https://fhir.meditouchehr.com/api/fhir/r4/
- ccheatam208246@ahs.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA070577 | NJ | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8271500 | Medicaid | NJ |
Other providers in Rutherford, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.