Mazen S. Itani, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

25MA08075500 Issued in NJ

Practice address

183 US Highway 206 Ste 2
Flanders, NJ 07836

Phone

(973) 705-7202

Fax

(973) 705-7262

NPI assigned

Feb 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

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

Specialty

General SurgeryAlso: Vascular Surgery

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Newton Medical Center Hospital, Newton, NJ, CCN 310028
• Chilton Medical Center Hospital, Pompton Plains, NJ, CCN 310017
• Ahs Hospital Corp Hospital, Hackettstown, NJ, CCN 310115

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mitani64904@direct.ahsys.org

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.

• Mazen Itani MD PC

  • Surgery Physician
  • Flanders, NJ
  • NPI 1821186586

  Vascular & Interventional Radiology

  Medicare reassignment NPD Authorized official
• Advanced Cardiology, LLC

  • Cardiovascular Disease Physician
  • Cedar Knolls, NJ
  • NPI 1295871796
  NPD (past)

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

• Ahs Hospital Corp

  • General Acute Care Hospital
  • Hackettstown, NJ
  • NPI 1518969419
  Care Compare affiliation
• Ahs Hospital Corp

  • General Acute Care Hospital
  • Newton, NJ
  • NPI 1790789212
  Care Compare affiliation
• Ahs Hospital Corp.

  • General Acute Care Hospital
  • Pompton Plains, NJ
  • NPI 1811994809
  Care Compare affiliation

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1770555930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 CRESTVIEW RD",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "070461224",
            "telephone_number": "973-705-7202",
            "fax_number": "973-705-7262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 US HIGHWAY 206 STE 2",
            "city": "FLANDERS",
            "state": "NJ",
            "postal_code": "07836",
            "telephone_number": "973-705-7202",
            "fax_number": "973-705-7262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITANI",
        "first_name": "MAZEN",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NJ",
            "license": "25MA08075500",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NJ",
            "license": "25MA08075500",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA08075500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chikara Hwang, PA-C
• Infinite Fitness and Health, LLC
• Integrated Health and Wellness Center of NJ, LLC
• International Brain Research Foundation
• Inverse, Inc
• Jeffrey Thoelen Counseling LLC
• Sneha M John, PHARMACIST
• Michael Joseph Juliano, D.M.D
• Jurneys, Inc.
• Vik Kapoor, OT

• Surgery Physician in Flanders, NJ
• Providers in Flanders, NJ by specialty
• Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.