NPIMap

Organization Active NPI

Naspac1 LLC

  • Durable Medical Equipment & Medical Supplies
  • Blackwood, NJ
National Provider Identifier
1013565332
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
NASPAC1 LLC
Practice address
4101 Route 42 Ste C
Blackwood, NJ 08012-1782
Phone
(856) 516-4566
Fax
(856) 516-4577
NPI assigned
Aug 29, 2019
Last updated
Jan 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Authorized official

Name
Sanjay Cheulkar
Title
Coo
Phone
(609) 410-9424

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Clinic Pharmacy 3336C0002X

Addresses

Primary practice location

4101 Route 42 Ste C
Blackwood, NJ 08012-1782

Mailing address

404 Creek Crossing Blvd # 404
Hainesport, NJ 08036-2768
Phone (609) 410-9424

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191118000447 NJ DME Supplier - Physician - Interventional Pain ManagementDME Supplier - Physician - Anesthesiology 1355563404 Practice locations: Blackwood, NJ

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • Naspac1 LLC

    dba North american spine and pain consultants

    • Pain Medicine (Anesthesiology) Physician
    • Hainesport, NJ
    • NPI 1528483245

    1355563404

    Same PAC ID
  • Naspac1 LLC
    • Interventional Pain Medicine Physician
    • East Orange, NJ
    • NPI 1720756216

    1355563404

    Same PAC ID

National Provider Directory

National Provider Directory
Tax ID family
Naspac1 LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

404 Creek Crossing Blvd
#404
Hainesport, NJ 08036

Practitioners & affiliated clinicians

Practitioners 1

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": "1567036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610928000000",
    "number": "1013565332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 CREEK CROSSING BLVD # 404",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362768",
            "telephone_number": "609-410-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 ROUTE 42 STE C",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080121782",
            "telephone_number": "856-516-4566",
            "fax_number": "856-516-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NASPAC1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-29",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A",
        "authorized_official_last_name": "CHEULKAR",
        "authorized_official_first_name": "SANJAY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "609-410-9424"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; 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.