NPIMap

Individual provider Active NPI

Kelley Brooke Mowatt-Pesce, DO

  • Hematology & Oncology Physician
  • Hackensack, NJ
National Provider Identifier
1841731049
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
25MB11777000 Issued in NJ
Practice address
92 2ND St
Hackensack, NJ 07601-2191
Phone
(551) 996-5900
NPI assigned
Mar 20, 2017
Last updated
Jun 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Hematology & Oncology Physician 207RH0003X 25MB11777000 NJ Primary

Addresses

Primary practice location

92 2ND St
Hackensack, NJ 07601-2191

Mailing address

92 2ND St
Hackensack, NJ 07601-2191
Phone (551) 996-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230504002456 NJ Practitioner - Hematology/Oncology 2860857380 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

218 A Sunset Rd
Willingboro, NJ 08046-1110
Phone (609) 835-2900

234 Hamburg Tpke
Wayne, NJ 07470-2173
Phone (609) 835-2900

30 Prospect Ave
Hackensack, NJ 07601-1915
Phone (844) 346-7222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.1 of 100Reported as subgroup
Quality
51.56
Promoting interoperability
100
Improvement activities
40
Cost
70.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB11777000NJMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Totowa Cancer Center Single Specialty CurrentSince Jan 13, 2024 Accepting new patients
Regional Cancer Care Associates LLC Single Specialty CurrentSince May 25, 2023 Accepting new patients
Regional Cancer Care Associates LLC Single Specialty CurrentSince May 25, 2023 Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

92 2nd St
Hackensack, NJ 07601
Phone (551) 996-2210

500 Frank W Burr Blvd
Ste 560
Teaneck, NJ 07666

225 Minnisink Rd
Totowa, NJ 07512
Phone (862) 657-3000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1841731049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 2ND ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012191",
            "telephone_number": "551-996-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 2ND ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076012191",
            "telephone_number": "551-996-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOWATT-PESCE",
        "first_name": "KELLEY",
        "middle_name": "BROOKE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-20",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NJ",
            "license": "25MB11777000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.