| Stationmd Professional Corporation | |
|
515 Valley St Ste 203 Maplewood NJ 07040-4300 | |
| (908) 663-2929 | |
| (908) 663-2913 |
| Full Name | Stationmd Professional Corporation |
|---|---|
| Speciality | Emergency Medicine |
| Location | 515 Valley St Ste 203, Maplewood, New Jersey |
| Authorized Official Name and Position | Deven Unadkat (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 9086632929 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stationmd Professional Corporation 515 Valley St Ste 203 Maplewood NJ 07040-4300 Ph: (908) 663-2929 | Stationmd Professional Corporation 515 Valley St Ste 203 Maplewood NJ 07040-4300 Ph: (908) 663-2929 |
| NPI Number | 1285015347 |
|---|---|
| Provider Enumeration Date | 06/15/2015 |
| Last Update Date | 05/07/2024 |
| Certification Date | 05/07/2024 |
| Medicare PECOS PAC ID | 6204184104 |
|---|---|
| Medicare Enrollment ID | O20180809001193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285015347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 207P00000X | Emergency Medicine | (* (Not Available)) | Primary |
| Provider Name | Victoria Cespedes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578660163 PECOS PAC ID: 6507804481 Enrollment ID: I20050421000040 |
| Provider Name | Scott Mankowitz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922115435 PECOS PAC ID: 6709884471 Enrollment ID: I20061114000178 |
| Provider Name | Mansoor A. Khan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114067667 PECOS PAC ID: 7113023912 Enrollment ID: I20070510000190 |
| Provider Name | Maulik Trivedi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023108941 PECOS PAC ID: 1456375880 Enrollment ID: I20081030000304 |
| Provider Name | Peter Kelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982869467 PECOS PAC ID: 5092995688 Enrollment ID: I20110215000332 |
| Provider Name | Deven J Unadkat |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205013810 PECOS PAC ID: 2466510722 Enrollment ID: I20120809000498 |
| Provider Name | Matthew Kaufman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831308626 PECOS PAC ID: 1254427180 Enrollment ID: I20121023000040 |
| Provider Name | Danielle Parisi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770731655 PECOS PAC ID: 4789836750 Enrollment ID: I20121221000023 |
| Provider Name | Robert P Greenblatt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104171198 PECOS PAC ID: 5597913889 Enrollment ID: I20130530000700 |
| Provider Name | Jason P. Boulware |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013211168 PECOS PAC ID: 8628236387 Enrollment ID: I20130624000121 |
| Provider Name | Stephen Kelly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558504258 PECOS PAC ID: 7113185117 Enrollment ID: I20130727000072 |
| Provider Name | Kristin Hughes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366882862 PECOS PAC ID: 0446493167 Enrollment ID: I20130828000772 |
| Provider Name | Betty Lim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548322522 PECOS PAC ID: 9830262096 Enrollment ID: I20140721002054 |
| Provider Name | Sigrid Hahn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912960287 PECOS PAC ID: 9234112855 Enrollment ID: I20181009001218 |
| Provider Name | Ershad Elahi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578726063 PECOS PAC ID: 8729234513 Enrollment ID: I20181009003359 |
| Provider Name | Mityanand Ramnarine |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215173927 PECOS PAC ID: 9032397245 Enrollment ID: I20181114000745 |
| Provider Name | Jayson Podber |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174698427 PECOS PAC ID: 1759284755 Enrollment ID: I20181212000414 |
| Provider Name | Glen Gutterson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205222528 PECOS PAC ID: 5991052243 Enrollment ID: I20200817003405 |
| Provider Name | Loras Even |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982960324 PECOS PAC ID: 1759695620 Enrollment ID: I20200818000777 |
| Provider Name | Benhoor Shamian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841435989 PECOS PAC ID: 0244530616 Enrollment ID: I20200819003508 |
| Provider Name | Michael Menna |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588907356 PECOS PAC ID: 2466744156 Enrollment ID: I20200819004319 |
| Provider Name | Omar Taha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841618303 PECOS PAC ID: 1355686312 Enrollment ID: I20200820001480 |
| Provider Name | Alexandra Elyse Murray |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932595287 PECOS PAC ID: 7517244296 Enrollment ID: I20201103000764 |
| Provider Name | Sin Chu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912387770 PECOS PAC ID: 9830510205 Enrollment ID: I20201103001473 |
| Provider Name | David Troy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659668317 PECOS PAC ID: 7517385677 Enrollment ID: I20201109002402 |
| Provider Name | Tanveer Shahabuddin Mollah Makker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891053252 PECOS PAC ID: 9739475039 Enrollment ID: I20220419000458 |
| Provider Name | Andrew Lee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295053700 PECOS PAC ID: 6305039272 Enrollment ID: I20220425002304 |
| Provider Name | Katelin Jean Williamson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477967859 PECOS PAC ID: 1850627530 Enrollment ID: I20220701001930 |
| Provider Name | Robin Kahn Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124203781 PECOS PAC ID: 6305213398 Enrollment ID: I20221103002854 |
| Provider Name | Dara L Heinlein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497861678 PECOS PAC ID: 4284630930 Enrollment ID: I20241121004911 |
| Provider Name | Akosua Anim Norgbey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831574011 PECOS PAC ID: 5799094728 Enrollment ID: I20250213000995 |
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