Individual provider Active NPI

Mira Gad, DO

  • Internal Medicine Physician
  • Moorestown, NJ
National Provider Identifier
1700448776
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MB11536300 Issued in NJ
Practice address
740 Marne Hwy Ste 206
Moorestown, NJ 08057-3126
Phone
(856) 778-4009
NPI assigned
Jun 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MB11536300 NJ Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

740 Marne Hwy Ste 206
Moorestown, NJ 08057-3126

Mailing address

8 Bruce CT
Milltown, NJ 08850-1302

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
I20221107002420 NJ Practitioner - Internal Medicine 2860869799 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
71.59
Promoting interoperability
100
Improvement activities
40
Cost
76.65

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB11536300NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care of New Jersey PC Internal Medicine CurrentSince Nov 1, 2022 Accepting new patients
Optum Medical Care of New Jersey PC CurrentSince Nov 1, 2022 Accepting new patients
Signify Health Medical Associates of New Jersey, LLC CurrentSince Apr 6, 2024 Accepting new patients
A.G. Dikengil, MD, PA Past Accepting new patients

Locations

935 River Rd
Ste 301
Edgewater, NJ 07020
Phone (201) 471-7012

116 Village Blvd
Ste 200
Princeton, NJ 08540
Phone (609) 285-3094

1 Harmon Plz
Fl 10
Secaucus, NJ 07094
Phone (201) 636-7233

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: mira.gad.1@20099.direct.athenahealth.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": "1561852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1700448776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 BRUCE CT",
            "city": "MILLTOWN",
            "state": "NJ",
            "postal_code": "088501302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 MARNE HWY STE 206",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080573126",
            "telephone_number": "856-778-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAD",
        "first_name": "MIRA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-30",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB11536300",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorestown, NJ

Sources for this page

Verify at the official NPI Registry.