NPIMap

Organization Active NPI

Rutgers Health-RWJ Scleroderma Program

  • Pediatric Adolescent Medicine Physician
  • New Brunswick, NJ
National Provider Identifier
1023055738
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
RUTGERS HEALTH-RWJ SCLERODERMA PROGRAM
Practice address
89 French St
Suite 2300
New Brunswick, NJ 08901-1935
Phone
(732) 235-6230
Fax
(732) 235-8766
NPI assigned
Jun 1, 2006
Last updated
Jan 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Authorized official

Name
Brenda Lawrence
Title
Director of Revenue Cycle
Phone
(732) 235-6070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X NU Primary

Addresses

Primary practice location

89 French St
Suite 2300
New Brunswick, NJ 08901-1935

Mailing address

66 West Gilbert St
Red Bank, NJ 07701
Phone (732) 212-0051

Other identifiers 1

IdentifierTypeStateIssuer
5133505MedicaidNJ

Other names 1

  • Rutgers Health-RWJ Pediatric Adolescent Medicine Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050401000109 NJ Part B Supplier - Clinic/Group Practice 8729035894 Receives reassigned benefits from 2 practitioners
Practice locations: New Brunswick, NJ
O20050502000326 NJ Part B Supplier - Clinic/Group Practice 5193764991 Receives reassigned benefits from 667 practitioners
38 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Brunswick, NJ; North Brunswick, NJ; Perth Amboy, NJ; Piscataway, NJ; Somerset, NJ; Somerville, NJ; Toms River, NJ; East Brunswick, NJ…

Other NPIs on the same Medicare enrollment 38

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

View all 38

National Provider Directory

National Provider Directory
Tax ID family
Rutgers Health - RWJ Clinical Genetics27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Locations

89 French St
Fl 2
New Brunswick, NJ 08901
Phone (732) 235-4980

Practitioners & affiliated clinicians

Practitioners 127

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.

View all 127

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1023055738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 WEST GILBERT ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "07701",
            "telephone_number": "732-212-0051",
            "fax_number": "732-212-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 FRENCH ST",
            "address_2": "SUITE 2300",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011935",
            "telephone_number": "732-235-6230",
            "fax_number": "732-235-8766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTGERS HEALTH-RWJ SCLERODERMA PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "732-235-6070"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5133505",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rutgers Health-RWJ Pediatric Adolescent Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.