Individual provider Active NPI

Sofia Mavasheva

  • Internal Medicine Physician
  • Trenton, NJ
National Provider Identifier
1851345995
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07092800 Issued in NJ
Practice address
2055 Klockner Rd
Trenton, NJ 08690-3413
Phone
(609) 586-8060
Fax
(609) 586-7470
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA07092800 NJ Primary

Addresses

Primary practice location

2055 Klockner Rd
Trenton, NJ 08690-3413

Mailing address

2055 Klockner Rd
Trenton, NJ 08690-3413
Phone (609) 586-8060

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060804000004 NJ Practitioner - Internal Medicine 5890708184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rwjbh Primary Care ServicesGroup PAC ID 0749699346, 266 clinicians

Practice addresses (Care Compare)

2055 Klockner Rd
Hamilton Square, NJ 08690-3413
Phone (609) 586-8060

Hospital & facility affiliations

  • Robert Wood Johnson Visiting Nurses, Inc Home health agency, North Brunswick, NJ, CCN 317079
  • Mercer Care Home health agency, Bordentown, NJ, CCN 317062
  • Robert Wood Johnson University Hospital at Hamilton Hospital, Hamilton, NJ, CCN 310110
  • Capital Health Medical Center - Hopewell Hospital, Pennington, NJ, CCN 310044
  • University Medical Center of Princeton at Plainsboro Hospital, Plainsboro, NJ, CCN 310010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07092800NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rwjbh Primary Care Services Internal Medicine CurrentSince May 29, 2021 Accepting new patients
Hamilton Internal Medicine LLC Current Accepting new patients

Locations

25 Kilmer Dr
Ste 107
Morganville, NJ 07751
Phone (732) 385-5262

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

166 Lyons Ave
Newark, NJ 07112
Phone (973) 926-7300

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

3 Executive Dr
Ste 400
Somerset, NJ 08873
Phone (732) 369-5949

2055 Klockner Rd
Trenton, NJ 08690
Phone (609) 586-8060

8 Mountain Blvd
Ste J
Warren, NJ 07059
Phone (732) 893-0200

Interoperability endpoints

  • Direct secure messaging: smavasheva15042@epicdirect.rwjbh.org

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1851345995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 KLOCKNER RD",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086903413",
            "telephone_number": "609-586-8060",
            "fax_number": "609-586-7470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 KLOCKNER RD",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086903413",
            "telephone_number": "609-586-8060",
            "fax_number": "609-586-7470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVASHEVA",
        "first_name": "SOFIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07092800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

Verify at the official NPI Registry.