Individual provider Active NPI

Anthony N Mishik, MD

  • Pediatrics Physician
  • West Deptford, NJ
National Provider Identifier
1699723668
Registry record updated Mar 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA05674000 Issued in NJ
Practice address
646 Kings Highway
West Deptford, NJ 08096
Phone
(856) 879-2887
Fax
(856) 879-2855
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA05674000 NJ Primary

Addresses

Primary practice location

646 Kings Highway
West Deptford, NJ 08096

Mailing address

402 Lippincott Dr
Marlton, NJ 08053-4112
Phone (856) 782-3300

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
I20200506002423 NJ Practitioner - General PracticePractitioner - Pediatric Medicine 7719976232 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA05674000NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare, LLC Pediatrics CurrentSince Mar 1, 2020 Accepting new patients
Advocare , LLC CurrentSince Feb 1, 1998 Accepting new patients
Advocare, LLC Pediatrics Past Accepting new patients
Inspira Medical Centers, Inc. Past Accepting new patients

Locations

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

402 Lippincott Dr
Marlton, NJ 08053
Phone (410) 763-8787

25 Lindsley Dr
Ste 205
Morristown, NJ 07960
Phone (973) 993-8777

19 Village Center Dr
Swedesboro, NJ 08085
Phone (856) 468-8330

646 Kings Hwy
West Deptford, NJ 08096
Phone (856) 879-2887

Interoperability endpoints

  • Direct secure messaging: anthony.mishik@advocaredoctors.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1699723668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 LIPPINCOTT DR",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534112",
            "telephone_number": "856-782-3300",
            "fax_number": "856-504-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 KINGS HIGHWAY",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "08096",
            "telephone_number": "856-879-2887",
            "fax_number": "856-879-2855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISHIK",
        "first_name": "ANTHONY",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA05674000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Deptford, NJ

Sources for this page

Verify at the official NPI Registry.