MMC Provider Services

Primary specialty

Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X

Legal business name

MMC PROVIDER SERVICES

Practice address

300 2ND Ave
Long Branch, NJ 07740-6303

Phone

(732) 557-8000

NPI assigned

Feb 10, 2017

Last updated

Jul 29, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacqueline Mintz

Title

Dir. Finance

Phone

(732) 423-7497

Specialties & licenses 3

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Monmouth Medical Center Inc

  dba Monmouth Medical Center Southern Campus

  • General Acute Care Hospital
  • Lakewood, NJ
  • NPI 1225133473

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ruric (Andy) Clesby Anderson, MD

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1205995255
  NPD (past)

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

{
    "created_epoch": "1486684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1932647872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 OLD SHORT HILLS RD",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521008",
            "telephone_number": "732-423-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 2ND AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406303",
            "telephone_number": "732-557-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95 Old Short Hills Rd",
            "address_purpose": "LOCATION",
            "city": "West Orange",
            "state": "NJ",
            "postal_code": "070521008",
            "country_code": "US",
            "telephone_number": "732-423-7497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MMC PROVIDER SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-10",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "MINTZ",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "DIR. FINANCE",
        "authorized_official_telephone_number": "732-423-7497"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mia Miller
• Stefanie Mirabella
• Amit C Misra, MD
• Beatrice Landman Mittman, PHD
• Masako Mizusawa, M.D.
• Moceans Center for Independent Living, Inc (Moceans Cil)
• Rachael Ann Keegan Moffett, MD
• Eman Baker Mohammad
• Gaurav Mohan, MBBS
• Debra J Molbegott, D.O.

• Critical Care Medicine (Anesthesiology) Physician in Long Branch, NJ
• Providers in Long Branch, NJ by specialty
• Critical Care Medicine (Anesthesiology) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.