MARK MICHAEL DO
NPI 1528296142
Pediatrics - Pediatric Cardiology in Newark, NJ
NPI Status: Active since June 23, 2009
Contact Information
201 LYONS AVE
SUITE L5
NEWARK, NJ
ZIP 07112
Phone: (973) 926-3500
- Individual
- Male
- Pediatrics
- Pediatric Cardiology
- Accepts Insurance
- PECOS Enrolled
About MARK MICHAEL
This page provides the complete NPI Profile along with additional information for Mark Michael, a pediatrician established in Newark, New Jersey with a medical specialization in Pediatrics, focusing in pediatric cardiology . The healthcare provider is registered in the NPI registry with number 1528296142 assigned on June 2009. The practitioner's primary taxonomy code is 2080P0202X with license number 25MB09737300 (NJ). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1528296142
- Provider Name
- MARK MICHAEL DO
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 201 LYONS AVE SUITE L5 NEWARK, NJ 07112
- Location Phone
- (973) 926-3500
- Mailing Address
- 201 LYONS AVE L5 NEWARK, NJ 07112
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 06-23-2009
- Last Update Date
- 05-02-2024
- Code Navigator
A pediatrician like Mark Michael is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics Pediatric Cardiology
- Taxonomy Code
- 2080P0202X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 25MB09737300
- License State
- NJ
- Taxonomy Description
- A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | 25MB08737300 (NJ) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Gold - EPO
- Clear Gold + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Principal Bronze HSA - EPO
- Principal Bronze HSA + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Mark Michael is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1528296142, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 68 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
NEWARK, NJ 07112
NEWARK, NJ 07112
NEWARK, NJ 07112
NEWARK, NJ 07112
NEWARK, NJ 07112
NEWARK, NJ 07112
NEWARK, NJ 07112
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1528296142, enumerated as an "individual" on June 23, 2009.
The provider is located at 201 LYONS AVE SUITE L5 NEWARK, NJ 07112 and the phone number is (973) 926-3500.
Pediatrics with taxonomy code 2080P0202X and a focus in Pediatric Cardiology.
The provider might be accepting Accepts: Ambetter Health and Ambetter Health of Delaware. Please consult your insurance carrier or call the provider to verify.
