Centrastate Medical Center, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CENTRASTATE MEDICAL CENTER, INC

Practice address

901 W Main St
Business Office
Freehold, NJ 07728-2537

Phone

(732) 294-7012

Fax

(732) 303-9251

NPI assigned

Mar 10, 2014

Organization subpart

Yes

Parent organization

CENTRASTATE MEDICAL CENTER, INC.As reported in NPPES

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

Authorized official

Name

Deborah Connors

Title

VP, Revenue Cycle

Phone

(732) 294-7052

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• MultiSpecialty Physicians of CentraState Other name

Tax ID family

Cesar R Quezada MD4 organizations share this tax ID, including this one

Part of

Cesar R Quezada MD

Other organizations with this tax ID 3

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

• Centrastate Medical Center, Inc

  • General Acute Care Hospital
  • Freehold, NJ
  • NPI 1295718450
  NPD tax ID
• Centrastate Medical Center, Inc

  • Clinical Medical Laboratory
  • Freehold, NJ
  • NPI 1699487801
  NPD tax ID
• Centrastate Medical Center, Inc

  • General Acute Care Hospital
  • Freehold, NJ
  • NPI 1861891913
  NPD tax ID

Locations

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602806400000",
    "number": "1023434529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST",
            "address_2": "BUSINESS OFFICE",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537",
            "telephone_number": "732-294-7012",
            "fax_number": "732-303-9251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST",
            "address_2": "BUSINESS OFFICE",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537",
            "telephone_number": "732-294-7012",
            "fax_number": "732-303-9251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRASTATE MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRASTATE MEDICAL CENTER, INC.",
        "enumeration_date": "2014-03-10",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A",
        "authorized_official_last_name": "CONNORS",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "VP, REVENUE CYCLE",
        "authorized_official_telephone_number": "732-294-7052"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4141008",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4141016",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4141024",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "091934",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MultiSpecialty Physicians of CentraState",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MultiSpecialty Physicians of CentraState",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Central Jersey Surgical Associates
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• Centrastate Medical Associates PC
• Centrastate Medical Center
• Centrastate Medical Center Inc.
• Centrastate Medical Center, Inc
• Centrastate Medical Center, Inc
• Centrastate Medical Center, Inc
• Centrastate Specialists, P.C.
• Mary Ann Cernak, PH.D., LCSW

• Family Medicine Physician in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; 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.