NPI Details
DR. Matin Mikayil Imanguli, MD, DDS is a plastic surgery within the head and neck otolaryngology in Edison, NJ with 13 years of experience. The provider is an otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them. DR. Matin Mikayil Imanguli, MD, DDS NPI is 1114065406. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
Education
Medical School: UNIVERSITY OF CHICAGO, PRITZKER SCHOOL OF MEDICINE
Graduation Year:2012
The provider's business location address is:
102 JAMES ST STE 302
EDISON, NJ
ZIP 08820-970
Phone: (732) 635-9300
The NPI 1114065406 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.
- Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
- Diagnostic exam of voice box using a flexible endoscope (HCPCS:31575)
- Established patient office or other outpatient visit, 40-54 minutes (HCPCS:99215)
- New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
- New patient office or other outpatient visit, 60-74 minutes (HCPCS:99205)
- Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
- Diagnostic exam of voice box using a flexible endoscope (HCPCS:31575)
- Upper gastrointestinal (GI) endoscopy for acid reflux (HCPCS:NAN12)
- Melanoma (skin cancer) excision (HCPCS:NAN03)
The enumeration date for this NPI number is 2/1/2007 and was last updated on 12/12/2023.
Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 122300000X | Dentist | | 0401411071 | VIRGINIA | No |
| 2 | 207Y00000X | Otolaryngology | | Q0461 | TEXAS | No |
| 3 | 207Y00000X | Otolaryngology | | 36041 | ALABAMA | No |
| 4 | 207Y00000X | Otolaryngology | | 25MA10294300 | NEW JERSEY | No |
| 5 | 207YX0007X | Otolaryngology | Plastic Surgery within the Head & Neck | 25MA10294300 | NEW JERSEY | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 542034392 | OTHER | VIRGINIA | TAX IDENTIFICATION |
| 2 | 113660124 | OTHER | VIRGINIA | TAX IDENTIFICATION |
| 3 | 841629676 | OTHER | VIRGINIA | TAX IDENTIFICATION |
