NPIMap

Organization Active NPI

Annandale Family Practice LLC

  • Primary Care Clinic/Center
  • Lebanon, NJ
National Provider Identifier
1003080169
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
25MA07764100 Issued in NJ
Legal business name
ANNANDALE FAMILY PRACTICE LLC
Practice address
56 Payne Rd
Suite 21
Lebanon, NJ 08833-3262
Phone
(908) 238-0100
Fax
(908) 238-0951
NPI assigned
Apr 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Theresa Ann Sacchieri, MDNPI 1578616942
Title
Provider/Owner
Phone
(201) 314-1139

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 25MA07764100 NJ Primary

Addresses

Primary practice location

56 Payne Rd
Suite 21
Lebanon, NJ 08833-3262

Mailing address

56 Payne Rd
Suite 21
Lebanon, NJ 08833-3262
Phone (908) 238-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080702000471 NJ Part B Supplier - Clinic/Group Practice 7416028527 Receives reassigned benefits from 4 practitioners
Practice locations: Pittstown, NJ; Lebanon, NJ; Flemington, NJ

National Provider Directory

National Provider Directory
Tax ID family
Annandale Family Practice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706140800000",
    "number": "1003080169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 PAYNE RD",
            "address_2": "SUITE 21",
            "city": "LEBANON",
            "state": "NJ",
            "postal_code": "088333262",
            "telephone_number": "908-238-0100",
            "fax_number": "908-238-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 PAYNE RD",
            "address_2": "SUITE 21",
            "city": "LEBANON",
            "state": "NJ",
            "postal_code": "088333262",
            "telephone_number": "908-238-0100",
            "fax_number": "908-238-0951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNANDALE FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A",
        "authorized_official_last_name": "SACCHIERI",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "201-314-1139",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NJ",
            "license": "25MA07764100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.