NPIMap

Individual provider Active NPI

Mina Fam, MD

  • Urology Physician
  • Brick, NJ
National Provider Identifier
1659661338
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
25MA10319400 Issued in NJ
Practice address
446 Jack Martin Blvd
Brick, NJ 08724
Phone
(732) 840-4300
NPI assigned
Apr 14, 2011
Last updated
Aug 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD458335 PA
Urology Physician 208800000X 25MA10319400 NJ Primary

Addresses

Primary practice location

446 Jack Martin Blvd
Brick, NJ 08724

Mailing address

446 Jack Martin Blvd
Brick, NJ 08724-7733
Phone (732) 840-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180614000547 NJ Practitioner - Urology 9830486083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Pennsylvania State University College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

446 Jack Martin Blvd
Brick, NJ 08724-7733
Phone (732) 840-4300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
98.14
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD458335PAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Urology Associates Enterprises Urology CurrentSince Sep 1, 2021 Accepting new patients
Urology Associates, PA Current Accepting new patients
Advanced Urology Associates Enterprises Urology CurrentSince Sep 1, 2021 Accepting new patients
Hands on Home Care Inc. PastSince Jun 10, 2019 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

446 Jack Martin Blvd
Brick, NJ 08724
Phone (732) 458-5300

2401 State Route 35
Manasquan, NJ 08736
Phone (732) 223-7877

444 Neptune Blvd
Unit 3
Neptune, NJ 07753
Phone (732) 988-3313

595 Shrewsbury Ave
Ste 103
Shrewsbury, NJ 07702
Phone (732) 741-5923

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc33586_urologyassociatespa
  • Direct secure messaging: minafammd@coastalurology.medentdirect.com

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 12

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": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1659661338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 JACK MARTIN BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247733",
            "telephone_number": "732-840-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 JACK MARTIN BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "08724",
            "telephone_number": "732-840-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAM",
        "first_name": "MINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-14",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "MD458335",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MA10319400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

Verify at the official NPI Registry.