NPIMap

Individual provider Active NPI

Michael Jeffrey Edwards, MD

  • Diagnostic Radiology Physician
  • Passaic, NJ
National Provider Identifier
1689644213
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25MA04966100 Issued in NJ
Practice address
350 Boulevard
Passaic, NJ 07055-2840
Phone
(973) 365-4300
Fax
(973) 365-9980
NPI assigned
Jan 25, 2006
Last updated
May 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 25MA04966100 NJ Primary

Addresses

Primary practice location

350 Boulevard
Passaic, NJ 07055-2840

Mailing address

935 Allwood Rd
Suite 230
Clifton, NJ 07012-1988
Phone (973) 365-2750

Other identifiers 1

IdentifierTypeStateIssuer
1000900MedicaidNJ

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
I20031231000587 NJ Practitioner - Diagnostic Radiology 8628977311 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shi Specialists LLCGroup PAC ID 7911449558, 48 clinicians

Practice addresses (Care Compare)

111 Central Ave
Newark, NJ 07102-1909
Phone (863) 902-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA04966100NJMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Passaic Imaging Associates LLC Diagnostic Radiology CurrentSince Jun 1, 2021 Accepting new patients
Northwest Radiology Associates PA Diagnostic Radiology CurrentSince Jun 1, 2021 Accepting new patients
Shi Specialists LLC CurrentSince Mar 1, 2025 Accepting new patients
Yonkers Imaging PC Diagnostic Radiology Past Accepting new patients
Sancor Medical Enterprises, LLC Diagnostic Radiology Past Accepting new patients
Geisinger Clinic Family Medicine Past Accepting new patients
FRG Acmh PC Diagnostic Radiology Past Accepting new patients
Diagnostic Radiology Assoc.,PA Specialist Past Accepting new patients
Vidya Malhotra Radiology PC Diagnostic Radiology Past Accepting new patients
Foundation Radiology Group PC Diagnostic Radiology PastSince Jan 21, 2022 Accepting new patients
Geisinger Clinic Selinsgrove Family Medicine Past Accepting new patients
Bergen County Improvement Authority Past Accepting new patients
Health Diagnostics of New Jersey, LLC Past Accepting new patients
Diagnostic Imaging of New York IV, P.C. Diagnostic Radiology Past Accepting new patients

Locations

25 Pocono Rd
Denville, NJ 07834
Phone (273) 625-6000

111 Central Ave
Newark, NJ 07102
Phone (973) 877-5060

3219 Route 46
Ste 110
Parsippany, NJ 07054
Phone (973) 334-1006

350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300

45 Pine St
Ste 8
Rockaway, NJ 07866

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 4

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1689644213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 ALLWOOD RD",
            "address_2": "SUITE 230",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121988",
            "telephone_number": "973-365-2750",
            "fax_number": "973-365-9980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 BOULEVARD",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070552840",
            "telephone_number": "973-365-4300",
            "fax_number": "973-365-9980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "MICHAEL",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA04966100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

Verify at the official NPI Registry.