Organization Active NPI

Jersey Shore Brachytherapy P a

  • Radiation Oncology Physician
  • Lakewood, NJ
National Provider Identifier
1013044585
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
JERSEY SHORE BRACHYTHERAPY P A
Practice address
900 Route 70 West
Lakewood, NJ 08701-5940
Phone
(732) 739-6476
Fax
(732) 739-2056
NPI assigned
Feb 28, 2007
Organization subpart
Yes
Parent organization
JERSEY SHORE BRACHYTHERAPY PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Authorized official

Name
Stewart A Berkowitz, MD
Title
President
Phone
(732) 739-6476

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

900 Route 70 West
Lakewood, NJ 08701-5940

Mailing address

6 Regal CT
Toms River, NJ 08753-5642
Phone (732) 739-6476

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040625000882 NJ Part B Supplier - Clinic/Group Practice 2466438908 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lakewood, NJ

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Jersey Shore Brachytherapy PA

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1013044585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 REGAL CT",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087535642",
            "telephone_number": "732-739-6476",
            "fax_number": "732-739-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 ROUTE 70 WEST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015940",
            "telephone_number": "732-739-6476",
            "fax_number": "732-739-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY SHORE BRACHYTHERAPY P A",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JERSEY SHORE BRACHYTHERAPY PA",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "BERKOWITZ",
        "authorized_official_first_name": "STEWART",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-739-6476",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.