Organization Active NPI

Amirata Surgical Associates

  • Surgery Physician
  • Belleville, NJ
National Provider Identifier
1710055918
Registry record updated Feb 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
AMIRATA SURGICAL ASSOCIATES
Practice address
5 Franklin Ave
Suite 406
Belleville, NJ 07109-3532
Phone
(973) 759-4499
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2011

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

Authorized official

Name
Dr. Edwin A Amirata, MDNPI 1437227600
Title
President
Phone
(973) 759-4499

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X NJ Primary

Addresses

Primary practice location

5 Franklin Ave
Suite 406
Belleville, NJ 07109-3532

Mailing address

5 Franklin Ave
Suite 406
Belleville, NJ 07109-3532
Phone (973) 759-4499

Other identifiers 1

IdentifierTypeStateIssuer
2933802MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050222000830 NJ Part B Supplier - Clinic/Group Practice 5799738498 Receives reassigned benefits from 2 practitioners
Practice locations: Belleville, NJ; Newark, NJ; Montclair, NJ; Harrison, NJ

National Provider Directory

National Provider Directory

Locations

5 Franklin Ave
Ste 406
Belleville, NJ 07109
Phone (973) 759-4490

Practitioners & affiliated clinicians

Practitioners 5

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": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298332800000",
    "number": "1710055918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 FRANKLIN AVE",
            "address_2": "SUITE 406",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071093532",
            "telephone_number": "973-759-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 FRANKLIN AVE",
            "address_2": "SUITE 406",
            "city": "BELLEVILLE",
            "state": "NJ",
            "postal_code": "071093532",
            "telephone_number": "973-759-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMIRATA SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2011-02-22",
        "status": "A",
        "authorized_official_last_name": "AMIRATA",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-759-4499",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2933802",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.