Nirandra Mahamitra, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MA082818 Issued in NJ

Practice address

504 White Horse Pike
Haddon Heights, NJ 08035

Phone

(856) 546-7990

NPI assigned

Aug 8, 2007

Last updated

Sep 12, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

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

Specialty

Family Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cooper Family Medicine PCGroup PAC ID 4284530197, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cooper University Hospital Hospital, Camden, NJ, CCN 310014

Merit-based Incentive Payment System (MIPS)

Final score

99.52 of 100Reported as apm

Quality

81.58

Promoting interoperability

99.4

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nmahamitra20402@direct.cooperhealth.edu

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.

• Cooper Family Medicine, PC

  • Family Medicine Physician
  • Cherry Hill, NJ
  • NPI 1649217175
  Medicare reassignment Care Compare group NPD
• Cooper Family Medicine PC

  • Family Medicine Physician
  • Moorestown, NJ
  • NPI 1093929895
  Medicare reassignment
• Cooper Family Medicine

  • Family Medicine Physician
  • Haddon Heights, NJ
  • NPI 1952504425
  NPD
• Cooper Family Medicine

  • Family Medicine Physician
  • Camden, NJ
  • NPI 1033312939
  NPD (past)
• The Cooper Health System

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1568442309
  NPD (past)
• Virtua Our Lady of Lourdes Hospital Inc

  dba Virtua Our Lady of Lourdes Hospital

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1235134024
  NPD (past)

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

• The Cooper Health System

  dba Cooper University Hospital

  • Land Ambulance
  • Camden, NJ
  • NPI 1174976724

  Hospital

  Care Compare affiliation
• The Cooper Health System

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1568442309
  Care Compare affiliation

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1669663217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST # 200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031088",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 WHITE HORSE PIKE",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "08035",
            "telephone_number": "856-546-7990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 S Black Horse Pike",
            "address_2": "suite 1",
            "address_purpose": "LOCATION",
            "city": "Blackwood",
            "state": "NJ",
            "postal_code": "080122975",
            "country_code": "US",
            "telephone_number": "856-232-6471",
            "fax_number": "856-232-7028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHAMITRA",
        "first_name": "NIRANDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA082818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1635355",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0141569",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6483065",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00428381",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ MEDICAL LICENSE",
            "identifier": "MA082818",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "010046054",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH, KEYSTONE, IBC",
            "identifier": "2861061000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lourdes Medical Associates, PA (Lourdes Medical Associates Social Services)
• Lourdes Medical Associates, PA (Lourdes Medical Associates Surgical Specialists)
• Lourdes Medical Associates, PA (Lourdes Medical Associates- Surgical Associates)
• Lourdes Medical Associates, PA
• Lourdes Surgical Associates
• Jay M Malamut, M.D.
• Roseann Mancini, LPC
• Christopher Manetta, D.O.
• Mario J. Arena, M.D., P.C.
• Mark Fisher MD Facr LLC

• Family Medicine Physician in Haddon Heights, NJ
• Providers in Haddon Heights, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.