Caduceus Medical Services LLC

Organization Active NPI Internal Medicine Physician · Brigantine, NJ

NPI 1053033993 · NPPES record last updated Sep 29, 2022

Key facts

NPI
1053033993
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
CADUCEUS MEDICAL SERVICES LLC
Practice address
503 Caverly Dr
Brigantine, NJ 08203-2819
Phone
(609) 317-6999
NPI assigned
Sep 16, 2022
Organization subpart
No

Authorized official

Name
Dr. Brendan Kelly, DO NPI 1629222781
Title
President
Phone
(609) 317-6999

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

Practitioners 2

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20221110000999 NJ Part B Supplier - Clinic/Group Practice 3779950308 Receives reassigned benefits from 2 practitioners
Practice locations: Brigantine, NJ

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207R00000X Yes

Addresses

Primary practice location

503 Caverly Dr
Brigantine, NJ 08203-2819

Mailing address

PO Box 300
Brigantine, NJ 08203-0300
Phone (609) 317-6999

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 29, 2022.

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664409600000",
    "number": "1053033993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 300",
            "city": "BRIGANTINE",
            "state": "NJ",
            "postal_code": "082030300",
            "telephone_number": "609-317-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 CAVERLY DR",
            "city": "BRIGANTINE",
            "state": "NJ",
            "postal_code": "082032819",
            "telephone_number": "609-317-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CADUCEUS MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "BRENDAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-317-6999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brigantine, NJ

All providers in Brigantine, NJ · Internal Medicine Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.