Mary Ann E Michelis, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

25MA03935600 Issued in NJ

Practice address

360 Essex Street
Suite 302
Hackensack, NJ 07601

Phone

(551) 996-2065

Fax

(551) 996-2169

NPI assigned

Mar 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249
  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507248000000",
    "number": "1710956073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 ESSEX STREET",
            "address_2": "SUITE 302",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "551-996-2065",
            "fax_number": "551-996-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 ESSEX STREET",
            "address_2": "SUITE 302",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "07601",
            "telephone_number": "551-996-2065",
            "fax_number": "551-996-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELIS",
        "first_name": "MARY ANN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2017-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NJ",
            "license": "25MA03935600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fanta Mian
• Erick Miao, DO
• Michael D Seidner, M.D.,Facog, P.a.
• Michael Esposito, M.D., LLC
• Zuzanna Michalak, MD
• Michael Michnya, PA
• Jessica Victoria Mierzejewski
• Elise Miguel, AU.D., CCC-A
• Malkhazi Mikadze, MD
• Nicole Fran Milch, LCSW

• Allergy & Immunology Physician in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Allergy & Immunology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.