NPIMap

Organization Active NPI

Mike Miron, M.D.,P.C.

  • Specialist
  • Fair Lawn, NJ
National Provider Identifier
1679870083
Registry record updated Feb 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MA04779200 Issued in NJ
Legal business name
MIKE MIRON, M.D.,P.C.
Practice address
40-04 Kilada CT
Fair Lawn, NJ 07410-5342
Phone
(201) 791-1178
Fax
(201) 791-6226
NPI assigned
Feb 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2011

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

Authorized official

Name
Mr. Mike Miron, M.D.
Title
President
Phone
(201) 791-1178

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 25MA04779200 NJ Primary

Addresses

Primary practice location

40-04 Kilada CT
Fair Lawn, NJ 07410-5342

Mailing address

40-04 Kilada CT
Fair Lawn, NJ 07410-5342
Phone (201) 791-1178

Other identifiers 3

IdentifierTypeStateIssuer
01026195MedicaidNY
1356425128OtherNPI FOR INDIVIDUAL PRACTITIONER MIKE MIRON,MD USED BY ALL INSURANCES
1974807MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1298246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298246400000",
    "number": "1679870083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40-04 KILADA CT",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074105342",
            "telephone_number": "201-791-1178",
            "fax_number": "201-791-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40-04 KILADA CT",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074105342",
            "telephone_number": "201-791-1178",
            "fax_number": "201-791-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIKE MIRON, M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-21",
        "last_updated": "2011-02-21",
        "status": "A",
        "authorized_official_last_name": "MIRON",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-791-1178",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA04779200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01026195",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR INDIVIDUAL PRACTITIONER MIKE MIRON,MD USED BY ALL INSURANCES",
            "identifier": "1356425128",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1974807",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.