NPIMap

Individual provider Active NPI

Divya Menon, M.D.

  • Cardiovascular Disease Physician
  • Freehold, NJ
National Provider Identifier
1730327834
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA08657500 Issued in NJ
Practice address
901 W Main St
Suite 205 Cn5050
Freehold, NJ 07728-2537
Phone
(732) 866-0800
Fax
(732) 463-6082
NPI assigned
Jan 27, 2009
Last updated
Mar 13, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MA08657500 NJ Primary
Nuclear Cardiology Physician 207UN0901X 25MA08657500 NJ

Addresses

Primary practice location

901 W Main St
Suite 205 Cn5050
Freehold, NJ 07728-2537

Mailing address

901 W Main St
Suite 205
Freehold, NJ 07728-2537
Phone (732) 866-0800

Other identifiers 1

IdentifierTypeStateIssuer
0321311MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120803000424 NJ Practitioner - Cardiovascular Disease (Cardiology) 9436305661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Robert Wood Johnson Physician EnterpriseGroup PAC ID 5597917633, 71 clinicians

Practice addresses (Care Compare)

901 W Main St
Suite 205
Freehold, NJ 07728-2537
Phone (732) 866-0800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.51 of 100Reported as apm
Quality
84.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA08657500NJMDCardiovascular Disease Physician

Interoperability endpoints

  • Direct secure messaging: dmenon15046@epicdirect.rwjbh.org
  • Direct secure messaging: dmenon425311@direct.ahsys.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1233014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489363200000",
    "number": "1730327834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST",
            "address_2": "SUITE 205",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537",
            "telephone_number": "732-866-0800",
            "fax_number": "732-463-6082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST",
            "address_2": "SUITE 205 CN5050",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537",
            "telephone_number": "732-866-0800",
            "fax_number": "732-463-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENON",
        "first_name": "DIVYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-27",
        "last_updated": "2017-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA08657500",
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NJ",
            "license": "25MA08657500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0321311",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.