Active NPI
Patrick Mascarenhas, DDS
- Prosthodontics
- Hoboken, NJ
National Provider Identifier
1881737088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 048968
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02691725 | Medicaid | NY | |
| 02099310 | Medicaid | NY | |
| 02691596 | Medicaid | NY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0489681 | NY | MD | General Practice Dentistry |
| 048968 | NY | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Dental Clinic/Center
- Beacon, NY
- NPI 1316333297
-
- General Practice Dentistry
- Hyde Park, NY
- NPI 1497926141
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.