Individual provider Active NPI

Masako Mizusawa, M.D.

  • Medical Microbiology Physician
  • Long Branch, NJ
National Provider Identifier
1962723619
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Microbiology PhysicianTaxonomy code 207ZM0300X
License
25MA11384400 Issued in NJ
Practice address
300 2ND Ave
Long Branch, NJ 07740-6303
Phone
(732) 222-5200
NPI assigned
Jun 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA11384400 NJ
Infectious Disease Physician 207RI0200X 2017007796 MO
Infectious Disease Physician 207RI0200X 25MA11384400 NJ
Medical Microbiology Physician 207ZM0300X 25MA11384400 NJ Primary

Addresses

Primary practice location

300 2ND Ave
Long Branch, NJ 07740-6303

Mailing address

2310 Holmes St
Ste 800
Kansas City, MO 64108-2602
Phone (816) 218-2523

Other practice location 1

2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-1885

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
I20230622002397 NJ Practitioner - Infectious DiseasePractitioner - Pathology 1052617131 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA11384400NJMDMedical Microbiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers Health-RWJ Pediatric Critical Care CurrentSince Feb 7, 2025 Accepting new patients
Id Care LLC Infectious Disease CurrentSince Jan 28, 2026 Accepting new patients

Locations

105 Raider Blvd
Ste 101
Hillsborough, NJ 08844
Phone (908) 281-0221

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

300 2nd Ave
Fl 3
Long Branch, NJ 07740
Phone (732) 222-5200

125 Paterson St
Ste 6140
New Brunswick, NJ 08901
Phone (732) 235-6230

1 Rwj Pl
New Brunswick, NJ 08901
Phone (732) 235-7887

1912 State Route 35
Ste 101
Oakhurst, NJ 07755
Phone (732) 222-4762

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

Organizations & group practices 3

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": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1962723619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 HOLMES ST",
            "address_2": "STE 800",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082602",
            "telephone_number": "816-218-2523",
            "fax_number": "816-285-6923"
        },
        {
            "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": "732-222-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Holmes St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641082640",
            "country_code": "US",
            "telephone_number": "816-404-1885",
            "fax_number": "816-404-1082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIZUSAWA",
        "first_name": "MASAKO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA11384400",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MO",
            "license": "2017007796",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "25MA11384400",
            "primary": false
        },
        {
            "code": "207ZM0300X",
            "taxonomy_group": "",
            "desc": "Pathology, Medical Microbiology",
            "state": "NJ",
            "license": "25MA11384400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Branch, NJ

Sources for this page

Verify at the official NPI Registry.