Middlesex Monmouth Gastroenterology

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

MIDDLESEX MONMOUTH GASTROENTEROLOGY

Practice address

222 Schanck Rd Ste 302
Freehold, NJ 07728-2974

Phone

(732) 577-1999

Fax

(732) 845-5356

NPI assigned

Dec 12, 2006

Organization subpart

No

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

Authorized official

Name

Susan Debard, MPA

Title

Administrator

Phone

(732) 577-1999

Specialties & licenses 3

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332979200000",
    "number": "1003977489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 SCHANCK RD STE 302",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282974",
            "telephone_number": "732-577-1999",
            "fax_number": "732-845-5356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 SCHANCK RD STE 302",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282974",
            "telephone_number": "732-577-1999",
            "fax_number": "732-845-5356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLESEX MONMOUTH GASTROENTEROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2012-03-29",
        "status": "A",
        "authorized_official_last_name": "DEBARD",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "732-577-1999",
        "authorized_official_credential": "MPA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID- MIDDLESEX COUNTY OFFICES",
            "identifier": "583237",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "31D0124927",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7110901",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine R Michael, D.O.
• Scott Michels, DDS
• Mid Atlantic Diabetes and Endocrinology Associates, LLC
• Mid State Gastroenterology LLC
• Mid-Atlantic Periodontics, PC
• Middlesex Monmouth Gastroenterology
• Midpoint Health Care Services, Inc.
• Midstate Rheumatology Center
• Marlena Mignano
• Megan Aileen Mihai

• All providers in Freehold, NJ
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.