Active NPI
Edgar Rafael Mejia, MD
- Pediatrics Physician
- Paterson, NJ
National Provider Identifier
1780645374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MA05988200
- Practice address
- 760 Market St.
Paterson, NJ 07513 - Phone
- (973) 523-8083
- Fax
- (973) 523-1133
- NPI assigned
- Mar 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MA059882 | NJ | |
| Pediatrics Physician | 208000000X | 25MA05988200 | NJ | Primary |
Addresses
Primary practice location
760 Market St.
Paterson, NJ 07513
Mailing address
760 Market St.
Paterson, NJ 07513
Phone (973) 523-8083
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6257402 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA05988200 | NJ | MD | Pediatrics Physician |
| MA059882 | NJ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Josephs University Medical Center Inc. | Past | Accepting new patients | |
| Edgar R. Mejia MD PA | Pediatrics | Past | Accepting new patients |
| HMH Hospitals Corporation | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Pediatrics Physician
- Paterson, NJ
- NPI 1265489116
-
dba Hackensack University Medical Center
- General Acute Care Hospital
- Hackensack, NJ
- NPI 1457456279
-
- General Acute Care Hospital
- Paterson, NJ
- NPI 1669462420
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384732800000",
"number": "1780645374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "760 MARKET ST.",
"city": "PATERSON",
"state": "NJ",
"postal_code": "07513",
"telephone_number": "973-523-8083",
"fax_number": "973-523-1133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 MARKET ST.",
"city": "PATERSON",
"state": "NJ",
"postal_code": "07513",
"telephone_number": "973-523-8083",
"fax_number": "973-523-1133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEJIA",
"first_name": "EDGAR",
"middle_name": "RAFAEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-31",
"last_updated": "2013-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "MA059882",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "25MA05988200",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6257402",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paterson, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.