Thomas R Mirsen, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MA54529 Issued in NJ

Practice address

3 Cooper PLZ
Suite 215 (Neurology)
Camden, NJ 08103-1438

Phone

(856) 342-2445

Fax

(856) 964-0504

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 12

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• CMC Department of Medicine Group PA

  • Cardiovascular Disease Physician
  • Camden, NJ
  • NPI 1609908094
  Medicare reassignment
• CMC Department of Medicine Group PA

  • Specialist
  • Camden, NJ
  • NPI 1386682094
  NPD
• CMC Department of Medicine Group PA

  • Neurology Physician
  • Sewell, NJ
  • NPI 1437281771
  NPD

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1902980352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 320",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-342-2445",
            "fax_number": "856-964-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 COOPER PLZ",
            "address_2": "SUITE 215 (NEUROLOGY)",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031438",
            "telephone_number": "856-342-2445",
            "fax_number": "856-964-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRSEN",
        "first_name": "THOMAS",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "MA54529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "010003879",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P440700",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7808502",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "3K6143",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1024720",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1243169",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH PPO",
            "identifier": "567399",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH, KEYSTONE, IBC",
            "identifier": "0388541000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0518267",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0651800",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110084266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY HEALTH PLAN",
            "identifier": "13517",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corbin Mills, CRNA, FNP
• Jennifer Lynn Milore, PSYD
• Nadia Minier-Johnson, NP
• Antonio V Minniti, RPH
• Miracles LLC
• Michael D Misbin, MD
• Sanjay Misra, MD
• Kelly Mission, CRNP
• Alissa Jacqueline Mitchell, DO
• Bharati T Mithani, MD

• Neurology Physician in Camden, NJ
• Providers in Camden, NJ by specialty
• Neurology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.