NPIMap

Organization Active NPI

Ear Nose Throat and Facial Plastic Surgery Associates PC

  • Facial Plastic Surgery Physician
  • Brick, NJ
National Provider Identifier
1033167671
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
Legal business name
EAR NOSE THROAT AND FACIAL PLASTIC SURGERY ASSOCIATES PC
Practice address
1608 Route 88
Suite 240
Brick, NJ 08724-3009
Phone
(732) 458-8575
Fax
(732) 206-0578
NPI assigned
May 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Authorized official

Name
Dr. James Clarke, M.D.NPI 1689665358
Title
Executive Vice President, Physician
Phone
(732) 765-6317

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X
Facial Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YS0123X Primary

Addresses

Primary practice location

1608 Route 88
Suite 240
Brick, NJ 08724-3009

Mailing address

PO Box 95000-8277
Philadelphia, PA 19195-0001
Phone (732) 807-0800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050331000687 NJ Part B Supplier - Clinic/Group Practice 2860449048 Receives reassigned benefits from 5 practitioners
Practice locations: Brick, NJ; Jackson, NJ

National Provider Directory

National Provider Directory

Locations

1608 State Route 88
Ste 240
Brick, NJ 08724
Phone (732) 458-8575

208 Jack Martin Blvd
Brick, NJ 08724
Phone (732) 458-8575

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1033167671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000-8277",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191950001",
            "telephone_number": "732-807-0800",
            "fax_number": "732-922-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 ROUTE 88",
            "address_2": "SUITE 240",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087243009",
            "telephone_number": "732-458-8575",
            "fax_number": "732-206-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR NOSE THROAT AND FACIAL PLASTIC SURGERY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT, PHYSICIAN",
        "authorized_official_telephone_number": "732-765-6317",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.