Active NPI
Amanda Mirmanesh, DO
- Obstetrics & Gynecology Physician
- Vineland, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 25MB11854600
- Practice address
- 2950 College Dr Ste 2D
Vineland, NJ 08360-6933 - Phone
- (856) 641-6313
- Fax
- (856) 497-5350
- NPI assigned
- May 3, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 25MB11854600 | NJ | Primary |
Addresses
Primary practice location
2950 College Dr Ste 2D
Vineland, NJ 08360-6933
Mailing address
1120 Delsea Dr N
Glassboro, NJ 08028-1444
Phone (856) 507-2783
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Philadelphia College of Osteopathic Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2950 College Dr
Suite 2D
Vineland, NJ 08360-6933
Phone (856) 641-6313
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Inspira Health Network Medical Group, P.C. | Multi-Specialty | Current | Accepting new patients |
Locations
1120 Delsea Dr N
Glassboro, NJ 08028
Phone (856) 205-7071
798 Centerton Rd
Pittsgrove, NJ 08318
Phone (856) 358-6161
2950 College Dr
Ste 2D
Vineland, NJ 08360
Phone (856) 641-6313
1505 W Sherman Ave
Vineland, NJ 08360
Phone (856) 451-6600
2466 E Chestnut Ave
Ste 2
Vineland, NJ 08361
Phone (856) 896-2814
17 W Red Bank Ave
Ste 104
Woodbury, NJ 08096
Phone (856) 848-0665
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.
-
- Multi-Specialty Clinic/Center
- Glassboro, NJ
- NPI 1922177856
-
- Obstetrics & Gynecology Physician
- Greenville, SC
- NPI 1801169966
NJ
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692230400000",
"number": "1871158030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 DELSEA DR N",
"city": "GLASSBORO",
"state": "NJ",
"postal_code": "080281444",
"telephone_number": "856-507-2783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2950 COLLEGE DR STE 2D",
"city": "VINELAND",
"state": "NJ",
"postal_code": "083606933",
"telephone_number": "856-641-6313",
"fax_number": "856-497-5350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRMANESH",
"first_name": "AMANDA",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-03",
"last_updated": "2023-08-17",
"certification_date": "2023-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": "NJ",
"license": "25MB11854600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vineland, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.