Individual provider Active NPI

Edward Brazaitis Sr., MD

  • Psychiatry Physician
  • East Orange, NJ
National Provider Identifier
1972614394
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MA66634 Issued in NJ
Practice address
385 Tremont Ave
East Orange, NJ 07018-1023
Phone
(973) 676-1000
NPI assigned
Aug 31, 2006
Sex
Male
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
Psychiatry Physician 2084P0800X MA66634 NJ Primary

Addresses

Primary practice location

385 Tremont Ave
East Orange, NJ 07018-1023

Mailing address

250 White Oak Ridge Rd
Short Hills, NJ 07078-1156

Other names 1

  • Dr. Edward Brazaitis Other name

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
I20110309000949 NJ Practitioner - Psychiatry 4486836616

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1979
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

393 Central Ave
Newark, NJ 07103-2842

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA66634NJMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Jersey Community Research Initiative CurrentSince Mar 31, 2021 Accepting new patients

Locations

393 Central Ave
Newark, NJ 07103
Phone (973) 483-3444

Interoperability endpoints

  • Direct secure messaging: eduardas.brazaitis.1@19575.direct.athenahealth.com

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972614394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 WHITE OAK RIDGE RD",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070781156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 TREMONT AVE",
            "city": "EAST ORANGE",
            "state": "NJ",
            "postal_code": "070181023",
            "telephone_number": "973-676-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAZAITIS",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "MA66634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDWARD",
            "last_name": "BRAZAITIS",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in East Orange, NJ

Sources for this page

Verify at the official NPI Registry.