Individual provider Active NPI

Maryanne Jaqueline Colenda, MD

  • Allergy & Immunology Physician
  • Fort Lee, NJ
National Provider Identifier
1629006143
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
25MA03161600 Issued in NJ
Practice address
811 Abbott Blvd
Fort Lee, NJ 07024-4101
Phone
(201) 224-2256
Fax
(201) 224-5577
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 25MA03161600 NJ Primary

Addresses

Primary practice location

811 Abbott Blvd
Fort Lee, NJ 07024-4101

Mailing address

811 Abbott Blvd
Fort Lee, NJ 07024-4101
Phone (201) 224-2256

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
I20051026000017 NJ Practitioner - Allergy/Immunology 8325065865 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
New York Medical College, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

811 Abbott Blvd
Fort Lee, NJ 07024-4101
Phone (201) 224-2256

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Alliance Group LLC Allergy & Immunology CurrentSince Nov 1, 2005 Accepting new patients
Hudson Hospital Opco LLC Current Accepting new patients
Tri America Health & Wellness CurrentSince Jul 12, 2023 Accepting new patients

Locations

2185 Lemoine Ave
Ste 1G
Fort Lee, NJ 07024
Phone (201) 881-9773

811 Abbott Blvd
Fort Lee, NJ 07024
Phone (201) 224-0127

Interoperability endpoints

  • Direct secure messaging: maryann.colenda@direct.christhospital.md

Organizations & group practices 3

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1629006143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 ABBOTT BLVD",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244101",
            "telephone_number": "201-224-2256",
            "fax_number": "201-224-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 ABBOTT BLVD",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244101",
            "telephone_number": "201-224-2256",
            "fax_number": "201-224-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLENDA",
        "first_name": "MARYANNE",
        "middle_name": "JAQUELINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NJ",
            "license": "25MA03161600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

Verify at the official NPI Registry.