Individual provider Active NPI

Nakul Mahajan, MD

  • Pain Medicine (Anesthesiology) Physician
  • Staten Island, NY
National Provider Identifier
1801061684
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
263983-1 Issued in NY
Practice address
3311 Hylan Blvd
Staten Island, NY 10306
Phone
(718) 448-3210
Fax
(718) 984-2642
NPI assigned
Apr 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 25MA08928700 NJ
Pain Medicine (Anesthesiology) Physician 207LP2900X 263983-1 NY Primary

Addresses

Primary practice location

3311 Hylan Blvd
Staten Island, NY 10306

Mailing address

2535 Arthur Kill Rd
Staten Island, NY 10309-1207
Phone (718) 448-3210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120814000514 NJ Practitioner - Anesthesiology 4284880857 Reassigns benefits to 1 organization
I20141022000716 NY Practitioner - AnesthesiologyPractitioner - Pain Management 4284880857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Resolute Perioperative Services LLCGroup PAC ID 9436546041, 19 clinicians

Practice addresses (Care Compare)

310 Salem Woodstown Rd
Salem, NJ 08079-2064
Phone (973) 294-6185

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
263983-1NYMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allspine Pain Management PC Current Accepting new patients
Lotus Anesthesiology Associates Current Accepting new patients
True North Medical Group PC CurrentSince Apr 1, 2020 Accepting new patients
Resolute Perioperative Services LLC CurrentSince Apr 8, 2024 Accepting new patients
True North Medical Group PC CurrentSince Apr 1, 2020 Accepting new patients
Keystone Group, LLC Past Accepting new patients

Locations

22 Old Short Hills Rd
Ste 112
Livingston, NJ 07039
Phone (973) 294-6185

310 Salem Woodstown Rd
Salem, NJ 08079
Phone (856) 339-6054

336 Woodstown Rd
Salem, NJ 08079
Phone (856) 339-4220

475 Prospect Ave
West Orange, NJ 07052
Phone (973) 325-6716

375 Mount Pleasant Ave
West Orange, NJ 07052
Phone (973) 322-6900

36 Lincoln Ave
Fl 3
Rockville Ctr, NY 11570

3311 Hylan Blvd
Ste 2
Staten Island, NY 10306

3311 Hylan Blvd
Staten Island, NY 10306
Phone (718) 351-3111

4236 Hylan Blvd
Staten Island, NY 10312
Phone 71881665001003

1099 Targee St
Staten Island, NY 10304

Interoperability endpoints

  • Direct secure messaging: nakulmahajan@nslijmedgr.allscriptsdirect.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1801061684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 ARTHUR KILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103091207",
            "telephone_number": "718-448-3210",
            "fax_number": "718-984-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10306",
            "telephone_number": "718-448-3210",
            "fax_number": "718-984-2642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAJAN",
        "first_name": "NAKUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "25MA08928700",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "263983-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.