NPIMap

Organization Active NPI

Advocare , LLC

  • Pediatrics Physician
  • Bayonne, NJ
National Provider Identifier
1043787781
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ADVOCARE , LLC
Practice address
1222 Kennedy Blvd
Bayonne, NJ 07002-9211
Phone
(201) 437-9600
NPI assigned
Oct 31, 2018
Last updated
Oct 31, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVOCARE , LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2018

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

Authorized official

Name
Charles McQueary
Title
Executive Vice President/Coo
Phone
(856) 782-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

1222 Kennedy Blvd
Bayonne, NJ 07002-9211

Mailing address

401 Route 73 N Ste 320
Marlton, NJ 08053-3426

Other practice location 1

3192 Kennedy Boulevard
3rd Floor
Union City, NJ 07087
Phone (201) 319-9800

Other names 1

  • Advocare Progressive Pediatrics Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2069557Advocare Progressive Pediatrics1222 Kennedy Boulevard, Bayonne, NJ 07002Certificate of waiverJan 3, 2027

National Provider Directory

National Provider Directory
Tax ID family
Advocare LLC250 organizations share this tax ID, including this one
Part of
Advocare LLC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540944000000",
    "number": "1043787781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ROUTE 73 N STE 320",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 KENNEDY BLVD",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070029211",
            "telephone_number": "201-437-9600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3192 Kennedy Boulevard",
            "address_2": "3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Union City",
            "state": "NJ",
            "postal_code": "07087",
            "country_code": "US",
            "telephone_number": "201-319-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVOCARE , LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVOCARE , LLC",
        "enumeration_date": "2018-10-31",
        "last_updated": "2018-10-31",
        "status": "A",
        "authorized_official_last_name": "MCQUEARY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT/COO",
        "authorized_official_telephone_number": "856-782-3300"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advocare Progressive Pediatrics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bayonne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.