Individual provider Active NPI

Bushra Mirza, M.D.

  • Mental Health Counselor
  • North Brunswick, NJ
National Provider Identifier
1679771315
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
292 Clinton Rd
North Brunswick, NJ 08902-3143
Phone
(732) 821-7139
NPI assigned
Jul 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

292 Clinton Rd
North Brunswick, NJ 08902-3143

Mailing address

292 Clinton Rd
North Brunswick, NJ 08902-3143
Phone (732) 821-7139

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
I20110825000294 NJ Practitioner - Psychiatry 2365612546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Princeton House Provider Group LLCGroup PAC ID 0244540540, 45 clinicians

Practice addresses (Care Compare)

905 Herrontown Rd
Princeton, NJ 08540-1901
Phone (609) 497-3300

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton House Provider Group LLC CurrentSince Sep 1, 2015 Accepting new patients
Princeton Healthcare System, a New Jersey Non-Profit Corporation Past Accepting new patients

Locations

993 Lenox Dr
Ste 207
Lawrenceville, NJ 08648

1460 Livingston Ave
Bldg 100
North Brunswick, NJ 08902
Phone (732) 729-3600

905 Herrontown Rd
Princeton, NJ 08540
Phone (609) 497-3300

Organizations & group practices 2

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": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679771315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 CLINTON RD",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089023143",
            "telephone_number": "732-821-7139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 CLINTON RD",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089023143",
            "telephone_number": "732-821-7139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "BUSHRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.