Individual provider Active NPI

Mitchell F. Mayer, D.O.

  • Family Medicine Physician
  • Iselin, NJ
National Provider Identifier
1639173008
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MB48348 Issued in NJ
Practice address
400 Gill LN
Iselin, NJ 08830-3001
Phone
(732) 404-1580
Fax
(732) 404-1594
NPI assigned
Jun 13, 2005
Last updated
Mar 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MB48348 NJ Primary

Addresses

Primary practice location

400 Gill LN
Iselin, NJ 08830-3001

Mailing address

400 Gill LN
Iselin, NJ 08830-3001
Phone (732) 404-1580

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
I20091221000223 NJ Practitioner - Family Practice 7911991773 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Avenel Iselin Medical Group, LLCGroup PAC ID 5597751941, 18 clinicians

Practice addresses (Care Compare)

400 Gill Lane
Iselin, NJ 08830-3059

400 Gill LN
Iselin, NJ 08830-3059
Phone (732) 404-1580

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB48348NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avenel Iselin Medical Group, LLC Family Medicine CurrentSince Jan 22, 1990 Accepting new patients

Locations

400 Gill Ln
Iselin, NJ 08830
Phone (732) 404-1580

Interoperability endpoints

  • Direct secure messaging: mitchellmayer@aimg.ssdirect.aprima.com

Organizations & group practices 1

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 7

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1639173008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 GILL LN",
            "city": "ISELIN",
            "state": "NJ",
            "postal_code": "088303001",
            "telephone_number": "732-404-1580",
            "fax_number": "732-404-1594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 GILL LN",
            "city": "ISELIN",
            "state": "NJ",
            "postal_code": "088303001",
            "telephone_number": "732-404-1580",
            "fax_number": "732-404-1594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYER",
        "first_name": "MITCHELL",
        "middle_name": "F.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MB48348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iselin, NJ

Sources for this page

Verify at the official NPI Registry.