Individual provider Active NPI

Michael A Nasr, DDS

  • Dentist
  • Metuchen, NJ
National Provider Identifier
1710488150
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22D102742600 Issued in NJ
Practice address
38 Bridge St BLDG a
Metuchen, NJ 08840-2277
Phone
(732) 549-0173
NPI assigned
Feb 21, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22D102742600 NJ Primary

Addresses

Primary practice location

38 Bridge St BLDG a
Metuchen, NJ 08840-2277

Mailing address

38 Bridge St BLDG a
Metuchen, NJ 08840-2277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180921000175 NY Order and Referring Only - Other (Non-Physician) 7618228263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22D102742600NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nasr Dental LLC Dentist Current Accepting new patients

Locations

38 Bridge St
Bldg A
Metuchen, NJ 08840
Phone (732) 549-0173

Organizations & group practices 1

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": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1710488150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 BRIDGE ST BLDG A",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 BRIDGE ST BLDG A",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402277",
            "telephone_number": "732-549-0173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASR",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-21",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D102742600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metuchen, NJ

Sources for this page

Verify at the official NPI Registry.