JAXON JAMES FERNANDES (NPI# 1073675740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073675740 |
| Entity Type | Individual |
| Full Name | JAXON JAMES FERNANDES |
| Credential | MD |
| Practice Address |
1 Clara Maass Dr Belleville NJ 07109-3550 |
| Mailing Address |
Po Box 708640 Sandy UT 84070-8640 |
| Practice Telephone | 9734502000 |
| Mailing Telephone | 8668692395 |
| Mailing Fax Number | 8013529502 |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2007-10-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 25MA08153000 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | RAIL ROAD MEDICARE | P00399307 | 01 |
| NJ | 0125237 | 05 |
| Street Address |
1 CLARA MAASS DR |
| City | BELLEVILLE |
| State | NJ |
| Zip Code | 07109-3550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811989924 | Mustafa A Abdul-hadi | Internal Medicine | 1 Clara Maass Dr, Belleville, NJ 07109-3550 | 2005-08-16 |
| 1467067736 | Amanda Krieger | Dietitian, Registered | 1 Clara Maass Dr, Belleville, NJ 07109-3550 | 2020-09-13 |
| 1598376501 | Ademola Adesola Ogunruku | Registered Nurse | 1 Clara Maass Dr, Belleville, NJ 07109-3550 | 2020-08-12 |
| 1821618711 | Jamilton B Carlon | Respiratory Therapist, Certified | 1 Clara Maass Dr, Belleville, NJ 07109-3550 | 2020-04-20 |
| 1649800814 | Kelsey Ann Vella | Physician Assistant | 1 Clara Maass Dr, Belleville, NJ 07109-3550 | 2020-01-16 |
| 1922649318 | Wendy Cheung | Physician Assistant | 1 Clara Maass Dr, Belleville, NJ 07109-3550 | 2019-10-07 |
| 1952952020 | Kathleen Villarino | Dietitian, Registered | 1 Clara Maass Dr, Belleville, NJ 07109-3550 | 2019-09-20 |
| 1083261309 | Tatyana Aponte | Dietitian, Registered | 1 Clara Maass Dr, Belleville, NJ 07109-3550 | 2019-08-21 |
| 1891348462 | Rose Parker | Physician Assistant | 1 Clara Maass Dr, Belleville, NJ 07109-3550 | 2019-07-22 |
| 1629621818 | Gina P Derito | Physician Assistant | 1 Clara Maass Dr, Belleville, NJ 07109-3550 | 2019-07-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851871370 | Mario Jr Millan | Clinic/Center | 114 Washington Avenue, Belleville, NJ 07109 | 2018-08-14 |
| 1881186641 | Wayne J Caputo Dpm | Podiatrist | 5 S Franklin Avenue, Belleville, NJ 07109 | 2018-06-06 |
| 1457842429 | Gout Institute of America | Anesthesiology | 727 Joralemon St., Belleville, NJ 07109 | 2018-05-24 |
| 1477078632 | Keith Pishna | Social Worker | 224 Washington Avenue, Belleville, NJ 07109 | 2017-08-09 |
| 1669915906 | Priyankaben Gajjar | Nurse Practitioner | 668 Mill St, Apt A5, Belleville, NJ 07109 | 2016-11-18 |
| 1861878829 | 1st Cerebral Palsy of New Jersey | Contractor | 31 Cuozzo Street, Belleville, NJ 07109 | 2015-07-31 |
| 1730562323 | 1st Cerebral Palsy of New Jersey | Contractor | 20-28 Rocco Street, Apartment 20, Belleville, NJ 07109 | 2015-07-01 |
| 1407241441 | Janet Labadie | Nurse Practitioner | 140 Belmont Avenue, Bellevile, NJ 07109 | 2015-04-06 |
| 1790180537 | Eshwary Yerramsetty | Pharmacist | 345 S Franklin Ave, Walgreens Pharmacy, Belleville, NJ 07109 | 2014-10-22 |
| 1477971794 | Molly Marie Murray | Physician Assistant | 1 Clara Maass Dr., Belleville, NJ 07109 | 2014-04-03 |
| Find all providers in zip 07109 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952953903 | Dr. Nesochi LLC | Internal Medicine | 50 Newark Ave Ste 108, Belleville, NJ 07109-1193 | 2019-07-10 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1730501206 | Maria Bernadette Bahena Yballe | Internal Medicine | 40 Bernice Rd, Belleville, NJ 07109-1508 | 2014-01-17 |
| 1578861787 | Medical Board Prep Inc | Internal Medicine | 5 Franklin Ave Ste 505, Belleville, NJ 07109-3566 | 2011-03-11 |
| 1558695494 | Paul Anthony Rusnack | Internal Medicine | 6 Sixteenth Green Ct, Belleville, IL 62220-4836 | 2009-09-24 |
| 1376785626 | Mustafa Sidali Do PC | Internal Medicine | 380 Union Ave, Belleville, NJ 07109-2122 | 2009-04-01 |
| 1003096140 | Dennis P Larson | Internal Medicine | 509 E Waters Edge Dr, Belleville, IL 62221-7813 | 2007-11-06 |
| 1336273119 | Jawad Khan | Internal Medicine | 8601 West Main Street, Suite 101, Belleville, IL 62223 | 2007-03-15 |
| 1649321183 | Ventrapragada S Mohan | Internal Medicine | 340 W Lincoln St Ste 300, Belleville, IL 62220-1900 | 2007-01-12 |
| 1710075452 | Francis Thomas Molinari | Internal Medicine | 625 Joralemon Street, Belleville, NJ 07109 | 2006-10-10 |
| Find all providers in BELLEVILLE | ||||
| City | BELLEVILLE |
| Zip Code | 07109 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.