Individual provider Active NPI

Feminia Castro Mac, MD

  • Pediatric Adolescent Medicine Physician
  • Newark, NJ
National Provider Identifier
1942386966
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
28330 Issued in NJ
Practice address
18 Ferry St
Newark, NJ 07105-1436
Phone
(973) 589-3566
Fax
(973) 589-1707
NPI assigned
Oct 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 28330 NJ Primary

Addresses

Primary practice location

18 Ferry St
Newark, NJ 07105-1436

Mailing address

18 Ferry St
Newark, NJ 07105-1436
Phone (973) 589-3566

Other identifiers 2

IdentifierTypeStateIssuer
28330OtherNJMEDICAL LICENSE
3921905MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20170220001822 NJ Practitioner - Pediatric Medicine 9830472794 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28330NJMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City of Newark CurrentSince Dec 7, 2016 Accepting new patients
City of Newark CurrentSince Dec 7, 2016 Accepting new patients
Eagle Health Services, LLC Past Accepting new patients
City of Newark Past Accepting new patients
City of Newark Past Accepting new patients

Locations

110 William St
Newark, NJ 07102
Phone (973) 424-4271

110 William St
Ste 110
Newark, NJ 07102

394 University Ave
Newark, NJ 07102
Phone (800) 734-7083

Interoperability endpoints

  • Direct secure messaging: feminia.mac.p1@direct.memhc.nextgenshare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942386966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 FERRY ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071051436",
            "telephone_number": "973-589-3566",
            "fax_number": "973-589-1707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 FERRY ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071051436",
            "telephone_number": "973-589-3566",
            "fax_number": "973-589-1707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAC",
        "first_name": "FEMINIA",
        "middle_name": "CASTRO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NJ",
            "license": "28330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "28330",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3921905",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.