Organization Active NPI

Head & Neck Surgical Group, LLC

  • Specialist
  • Hackensack, NJ
National Provider Identifier
1063509800
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
HEAD & NECK SURGICAL GROUP, LLC
Practice address
20 Prospect Ave Ste 613
Hackensack, NJ 07601-1962
Phone
(212) 262-9500
Fax
(551) 228-7606
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Larry Perlstein
Title
Administrator
Phone
(516) 423-9082

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

20 Prospect Ave Ste 613
Hackensack, NJ 07601-1962

Mailing address

20 Prospect Ave Ste 613
Hackensack, NJ 07601-1962
Phone (212) 262-9500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080708000273 NY Part B Supplier - Clinic/Group Practice 4880787852 Receives reassigned benefits from 9 practitioners
Practice locations: New York, NY
O20231031002400 NJ Part B Supplier - Clinic/Group Practice 4880787852 Receives reassigned benefits from 1 practitioner
Practice locations: Hackensack, NJ

National Provider Directory

National Provider Directory

Locations

20 Prospect Ave
Ste 613
Hackensack, NJ 07601
Phone (201) 489-6520

425 W 59th St
Fl 10
New York, NY 10019
Phone (212) 262-4444

Practitioners & affiliated clinicians

Practitioners 9

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": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1063509800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE STE 613",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011962",
            "telephone_number": "212-262-9500",
            "fax_number": "515-228-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE STE 613",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011962",
            "telephone_number": "212-262-9500",
            "fax_number": "551-228-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAD & NECK SURGICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "PERLSTEIN",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "516-423-9082"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.