NPIMap

Individual provider Active NPI

Patrycja Mika

  • Pharmacist
  • Jackson, NJ
National Provider Identifier
1982117156
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI04234500 Issued in NJ
Practice address
430 Harmony Rd
Jackson, NJ 08527-4417
Phone
(732) 928-6246
NPI assigned
Nov 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0014099 CT
Pharmacist 183500000X 28RI04234500 NJ Primary

Addresses

Primary practice location

430 Harmony Rd
Jackson, NJ 08527-4417

Mailing address

99 Ridge Ave
Staten Island, NY 10304-1420
Phone (347) 751-2504

Other practice location 1

1606 Barnum Ave
Stratford, CT 06614-5301
Phone (203) 377-2851

Other practice location 2

1000 Park Ave
Bridgeport, CT 06604-3406
Phone (203) 696-0127

Other practice location 3

275 Monroe Tpke
Monroe, CT 06468-2246
Phone (203) 268-1216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0014099CTMDPharmacist
28RI04234500NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Jan 22, 2023 Accepting new patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients
Walgreen Co PastSince Feb 27, 2022 Accepting new patients
Walgreen Co PastSince Jan 22, 2023 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1982117156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 RIDGE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041420",
            "telephone_number": "347-751-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 HARMONY RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085274417",
            "telephone_number": "732-928-6246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1606 Barnum Ave",
            "address_purpose": "LOCATION",
            "city": "Stratford",
            "state": "CT",
            "postal_code": "066145301",
            "country_code": "US",
            "telephone_number": "203-377-2851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "CT",
            "postal_code": "066043406",
            "country_code": "US",
            "telephone_number": "203-696-0127",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "275 Monroe Tpke",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "CT",
            "postal_code": "064682246",
            "country_code": "US",
            "telephone_number": "203-268-1216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIKA",
        "first_name": "PATRYCJA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-09",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "0014099",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04234500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.