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
- Title
- President
- Phone
- (609) 317-6999
Practitioners 2
-
Brendan S Kelly, DO
-
Suzanne F McGettigan, ACNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
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
{
"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
- Michael E Becker
- Board of Education City of Brigantine
- Brigantine Eye Care Center
- Brigantine Medical Group PA
- Brigantine Physical Therapy and Fitness LLC
- Michael Anthony Caromano
- Harry L Chaikin
- Lynn Chelucci
- City of Brigantine
- Coastal Physical Therapy and Wellness LLC
All providers in Brigantine, NJ · Internal Medicine Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.