NPIMap

Organization Active NPI

Monmouth Healthcare Services

  • Methadone Clinic
  • Brick, NJ
National Provider Identifier
1043847304
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
MONMOUTH HEALTHCARE SERVICES
Practice address
495 Jack Martin Blvd Ste 6
Brick, NJ 08724-7778
Phone
(856) 558-3250
NPI assigned
Mar 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Authorized official

Name
Mr. Christopher Bass
Title
Ceo
Phone
(856) 558-3250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary

Addresses

Primary practice location

495 Jack Martin Blvd Ste 6
Brick, NJ 08724-7778

Mailing address

10 Lincoln Ave
Collingswood, NJ 08108-3706
Phone (856) 558-3250

Other names 1

  • Harbor MAT Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Opioid treatment program
Medicare-enrolled since May 22, 2021

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210921000582 NJ Part B Supplier - Opioid Treatment Program (Otp) 0244637189 Practice locations: Brick, NJ

National Provider Directory

National Provider Directory
Tax ID family
Harbor Mat2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

495 Jack Martin Blvd
Ste 6
Brick, NJ 08724
Phone (732) 344-0596

Practitioners & affiliated clinicians

Practitioners 5

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": "1585180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631836800000",
    "number": "1043847304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LINCOLN AVE",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081083706",
            "telephone_number": "856-558-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 JACK MARTIN BLVD STE 6",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247778",
            "telephone_number": "856-558-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONMOUTH HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-26",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "856-558-3250",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harbor MAT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Harbor MAT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 17, 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.