Carmelita Mabanta, M.D.

Primary specialty

Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X

License

25MA08961100 Issued in NJ

Practice address

19 Davis Ave
Neptune, NJ 07753-4488

Phone

(732) 776-4524

Fax

(732) 776-4639

NPI assigned

Nov 28, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carmelita.mabanta@direct.hackensackmeridian.org
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
• FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

• Hackensack Meridian Health Medical Group - Complex Care PC

  • Internal Medicine Physician
  • Red Bank, NJ
  • NPI 1154379626

  Pediatrics

  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249

  Pediatrics

  Medicare reassignment NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Psychologist
  • Red Bank, NJ
  • NPI 1609593722
  NPD (past)
• Ar Medical LLC

  • Internal Medicine Physician
  • Hinesville, GA
  • NPI 1164472478

  Pediatrics

  NPD (past)
• Ar Medical LLC

  • Primary Care Clinic/Center
  • Dalton, GA
  • NPI 1619037769
  NPD (past)
• Ar Medical LLC

  • Primary Care Clinic/Center
  • Hephzibah, GA
  • NPI 1659431708
  NPD (past)
• San Pablo Clinic, LLC

  • Primary Care Clinic/Center
  • Dalton, GA
  • NPI 1689078842
  NPD (past)

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1801879598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 DAVIS AVE",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534488",
            "telephone_number": "732-776-4524",
            "fax_number": "732-776-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 DAVIS AVE",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077534488",
            "telephone_number": "732-776-4524",
            "fax_number": "732-776-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABANTA",
        "first_name": "CARMELITA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "052399",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NJ",
            "license": "25MA08961100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "547197362B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0304565",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Ann Lucarelli, RN MSN APRNBC CPNP
• Palak Lunia, PSY.D.
• Bridget Lysaght, BCBA
• Manhong Ma, MD
• Kurt Maass
• Matthew J Maccarrick, MD
• Maya Madhavan
• Uchenna Anthony Madubuko, M.D.
• Rachel Magee, PA
• Magellan Wellness & Performance

• Neonatal-Perinatal Medicine Physician in Neptune, NJ
• Providers in Neptune, NJ by specialty
• Neonatal-Perinatal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.