Menlo Park Medical Group P.a.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

MENLO PARK MEDICAL GROUP P.A.

Practice address

111 James Street
Edison, NJ 08820-3967

Phone

(732) 549-2299

Fax

(732) 549-2262

NPI assigned

Jul 24, 2006

Last updated

Aug 8, 2023By 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

Grace Creighton

Title

Office Manager

Phone

(732) 549-2299

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Girija Gopal Bhakey, MD

  • Internal Medicine Physician
  • Edison, NJ
  • NPI 1184646754
  Medicare reassignment Care Compare group NPD
• Warren Gregory Buck, MD

  • Cardiovascular Disease Physician
  • Edison, NJ
  • NPI 1720019532

  Internal Medicine

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1992727564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 JAMES STREET",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203967",
            "telephone_number": "732-549-2299",
            "fax_number": "732-549-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 JAMES STREET",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088203967",
            "telephone_number": "732-549-2299",
            "fax_number": "732-549-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENLO PARK MEDICAL GROUP P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "CREIGHTON",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "732-549-2299"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2627809",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eddie E Mendez, PA-C
• Premilla Mendonca, APN-C
• Mylene Daligues Mendoza
• Rosa M. Mendoza, M.D
• Tatiana Girma Mengistu, MD
• Menlo Park Surgery Center, LLC.
• Pinali Javeri Menon, DDS
• Donna A Mensch
• Tova Mensch, BCBA
• Vito Menza, DMD

• Cardiovascular Disease Physician in Edison, NJ
• Providers in Edison, NJ by specialty
• Cardiovascular Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.