NPIMap

Organization Active NPI

St Michael Infectious Disease Associates

  • Infectious Disease Physician
  • Newark, NJ
National Provider Identifier
1811942766
Registry record updated May 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MA060236 Issued in NJ
Legal business name
ST MICHAEL INFECTIOUS DISEASE ASSOCIATES
Practice address
265 Dr Martin Luther King Jr Blvd
Newark, NJ 07102-2012
Phone
(973) 877-2586
NPI assigned
May 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2009

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

Authorized official

Name
Dr. Stephen Smith, MDNPI 1104875814
Title
Owner
Phone
(973) 877-2586

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RI0200X MA060236 NJ Primary

Addresses

Primary practice location

265 Dr Martin Luther King Jr Blvd
Newark, NJ 07102-2012

Mailing address

PO Box 36
Roseland, NJ 07068-0036
Phone (201) 512-9494

Other identifiers 1

IdentifierTypeStateIssuer
8420301MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243382400000",
    "number": "1811942766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36",
            "city": "ROSELAND",
            "state": "NJ",
            "postal_code": "070680036",
            "telephone_number": "201-512-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 DR MARTIN LUTHER KING JR BLVD",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071022012",
            "telephone_number": "973-877-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MICHAEL INFECTIOUS DISEASE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2009-05-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-877-2586",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "MA060236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8420301",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.