DR. MAVIS CAMALITA ERMAKOV (R.D., RN., CDE., APN) – Family Nurse Practitioner, NPI 1265614911
Family Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. MAVIS CAMALITA ERMAKOV (R.D., RN., CDE., APN)
741 BROADWAY
NEWARK, NJ 071044309
Phone: (973) 483-1300
Type: Location
731 Liberty Ct
Piscataway, NJ 088547206
Phone: (732) 937-5952
Type: Location
78, Kenmore Avenue, Newark, Essex County, New Jersey, 07106, United States
NEWARK, NJ 071061026
Phone: (973) 399-3393
Type: Mailing
731 LIBERTY CT
PISCATAWAY, NJ 088547206
Phone: (732) 937-5952
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2015-07-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150714000714 | I | Nurse Practitioner | NJ | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 07104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | FL | |
| O B S T E T R I C S/ G Y N E C O L O G Y | NY | |
| Nurse Practitioner | NJ | |
| - | NJ | |
| Internal Medicine, Pediatric Medicine | NJ | |
| Nurse Practitioner | NJ | |
| Nurse Practitioner | NJ | |
| O B S T E T R I C S/ G Y N E C O L O G Y | NJ | |
| Nurse Practitioner | NJ | |
| P O D I A T R Y | NJ |
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