Sivam Diabetes & Primary Care LLC
NPI 1710525662ActiveOrganization· Nurse Practitioner, Family· Newark, NJ
Nurse Practitioner, Family in Newark, New Jersey, registered in NPPES in December 2019. The authorized official on file is Mavis Camalita Ermakov, DNP, APN, FHNP-BC, R, Director/Ceo.
Overview
| NPI | 1710525662 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 11, 2019 |
| Last updated in NPPES | Sep 1, 2021 |
| Certified by provider | Aug 16, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
| Dietitian, Registered | 133V00000X | — | — |
| Registered Nurse, Diabetes Educator | 163WD0400X | — | — |
| Clinic/Center, Health Services | 261QH0100X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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