Mavis Ermakov, R.D., RN., CDE., APN
NPI 1265614911 · Family Nurse Practitioner · Newark, NJ
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1265614911
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- R.D., RN., CDE., APN
- Sex
- Female
- Sole proprietor
- No
- License
- 0071705 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Dietary & Nutritional Service Providers
Dietary & Nutritional Service Providers
Nursing Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 731 Liberty CtPiscataway, NJ 08854-7206Phone: (732) 937-5952
Registry dates
- Enumerated
- 2007-12-04
- Last updated
- 2021-08-17
- Certified
- 2021-08-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.