Individual provider Active NPI

Patrick Mascarenhas, DDS

  • Prosthodontics
  • Hoboken, NJ
National Provider Identifier
1881737088
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
048968 Issued in NY
Practice address
79 Hudson St Ste 2
Hoboken, NJ 07030-5638
Phone
(917) 533-3673
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0489681 NY
Prosthodontics 1223P0700X 048968 NY Primary

Addresses

Primary practice location

79 Hudson St Ste 2
Hoboken, NJ 07030-5638

Mailing address

21 Lenox Rd
Summit, NJ 07901-3704
Phone (917) 533-3673

Other practice location 1

343 Warrior Road
Fort Stewart, GA 31314
Phone (912) 435-5546

Other identifiers 3

IdentifierTypeStateIssuer
02691725MedicaidNY
02099310MedicaidNY
02691596MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0489681NYMDGeneral Practice Dentistry
048968NYMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Tru-Dental, P.C. General Practice Current Accepting new patients
Prospect Dental, PC Current Accepting new patients

Locations

79 Hudson St
Ste 504
Hoboken, NJ 07030
Phone (845) 649-6943

288 Main St
Beacon, NY 12508
Phone (845) 838-0086

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.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1881737088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 LENOX RD",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079013704",
            "telephone_number": "917-533-3673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 HUDSON ST STE 2",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305638",
            "telephone_number": "917-533-3673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "343 Warrior Road",
            "address_purpose": "LOCATION",
            "city": "Fort Stewart",
            "state": "GA",
            "postal_code": "31314",
            "country_code": "US",
            "telephone_number": "912-435-5546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASCARENHAS",
        "first_name": "PATRICK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0489681",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "048968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02691725",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02099310",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02691596",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.