DR. MAVIS CAMALITA ERMAKOV R.D., RN., CDE., APN
NPI 1265614911
Nurse Practitioner - Family in Newark, NJ
About Dr. Mavis Camalita Ermakov R.d., Rn., Cde., Apn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MAVIS CAMALITA ERMAKOV R.D., RN., CDE., APN (NPI 1265614911) is an individual family provider in Newark, New Jersey, licensed in New Jersey (26NJ00421400) and active in the NPI registry since December 2007. She is enrolled in Medicare PECOS and maintains a secondary practice location in Piscataway.
NPPES Registry Identity
Specialties & Licenses 4
Secondary Practice Location 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Mavis Camalita Ermakov R.d., Rn., Cde., Apn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 07104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Referred Medical Equipment & Supplies CMS DME claims
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mavis Ermakov's NPI number?
The NPI number for Mavis Ermakov is 1265614911. It was assigned to this individual provider in the NPPES registry on December 4, 2007.
Where is Mavis Ermakov located?
Mavis Ermakov practices at 741 Broadway, Newark, NJ 07104. The listed phone number is (973) 483-1300.
What is Mavis Ermakov's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Mavis Ermakov enrolled in Medicare?
Yes. Mavis Ermakov is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Mavis Ermakov was last updated on August 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Mavis Camalita Ermakov, R.D., RN., CDE., APN · NPI 1265614911
Family physician in Newark, New Jersey. Individual provider, active in the CMS NPPES registry since December 4, 2007.
## Identity
- **NPI:** 1265614911 (Entity type: Individual)
- **Enumerated:** December 4, 2007
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 26NJ00421400 (New Jersey)
- **Sole proprietor:** No
## Practice location
- **Address:** 741 BROADWAY, Newark, NJ 07104-4309
- **Phone:** (973) 483-1300
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** August 17, 2021
- **Other identifiers:** Medicaid 0143533620 (NJ)
---
Source: [NPI Profile](https://npiprofile.com/npi/1265614911) · Data from the CMS NPPES public registry.