NPIMap

Organization Active NPI

New Jersey Preventive Cardiology

  • Cardiovascular Disease Physician
  • Trenton, NJ
National Provider Identifier
1013188655
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MA31053 Issued in NJ
Legal business name
NEW JERSEY PREVENTIVE CARDIOLOGY
Practice address
416 Bellevue Ave
Suite 303
Trenton, NJ 08618-4513
Phone
(609) 396-6363
Fax
(609) 695-7747
NPI assigned
Mar 21, 2008
Last updated
Jun 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Authorized official

Name
Rolando L Degoma, MDNPI 1194724195
Title
Owner
Phone
(609) 396-6363

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MA31053 NJ Primary

Addresses

Primary practice location

416 Bellevue Ave
Suite 303
Trenton, NJ 08618-4513

Mailing address

416 Bellevue Ave
Suite 303
Trenton, NJ 08618-4513
Phone (609) 396-6363

National Provider Directory

National Provider Directory

Locations

416 Bellevue Ave
Ste 303
Trenton, NJ 08618
Phone (609) 396-6363

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1013188655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 BELLEVUE AVE",
            "address_2": "SUITE 303",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086184513",
            "telephone_number": "609-396-6363",
            "fax_number": "609-695-7747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 BELLEVUE AVE",
            "address_2": "SUITE 303",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086184513",
            "telephone_number": "609-396-6363",
            "fax_number": "609-695-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY PREVENTIVE CARDIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-21",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "DEGOMA",
        "authorized_official_first_name": "ROLANDO",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-396-6363",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "MA31053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.