Individual provider Active NPI

Nathan Mohseni, D.O.

  • Emergency Medicine Physician
  • Newark, NJ
National Provider Identifier
1881901940
Registry record updated Sep 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
25MB08335200 Issued in NJ
Practice address
111 Central Ave
Newark, NJ 07102-1909
Phone
(973) 877-2317
NPI assigned
Sep 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 25MB08335200 NJ Primary

Addresses

Primary practice location

111 Central Ave
Newark, NJ 07102-1909

Mailing address

3210 Da Vinci Dr
Philadelphia, PA 19145-5768
Phone (484) 919-1297

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110923000393 FL Practitioner - Emergency Medicine 4183895196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB08335200NJMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince Dec 1, 2013 Accepting new patients

Locations

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

Organizations & group practices 1

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": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283990400000",
    "number": "1881901940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 DA VINCI DR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191455768",
            "telephone_number": "484-919-1297",
            "fax_number": "215-465-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CENTRAL AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021909",
            "telephone_number": "973-877-2317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHSENI",
        "first_name": "NATHAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NJ",
            "license": "25MB08335200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.