Active NPI
Daniel Peter Mirro, M.D.
- Psychiatry Physician
- Marlton, NJ
National Provider Identifier
1780707281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 25MA02486000
- Practice address
- 999 Route 73 N
Suite 200
Marlton, NJ 08053-1227 - Phone
- (856) 802-6888
- Fax
- (856) 802-6878
- NPI assigned
- Apr 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 25MA02486000 | NJ | Primary |
Addresses
Primary practice location
999 Route 73 N
Suite 200
Marlton, NJ 08053-1227
Mailing address
999 Route 73 N
Suite 200
Marlton, NJ 08053-1227
Phone (856) 802-6888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 16, 2016 through Mar 16, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA02486000 | NJ | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391472000000",
"number": "1780707281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "999 ROUTE 73 N",
"address_2": "SUITE 200",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080531227",
"telephone_number": "856-802-6888",
"fax_number": "856-802-6878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "999 ROUTE 73 N",
"address_2": "SUITE 200",
"city": "MARLTON",
"state": "NJ",
"postal_code": "080531227",
"telephone_number": "856-802-6888",
"fax_number": "856-802-6878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRRO",
"first_name": "DANIEL",
"middle_name": "PETER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-09",
"last_updated": "2014-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NJ",
"license": "25MA02486000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marlton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.