NPIMap

Organization Active NPI

Optum Medical Care of New Jersey PC

Doing business as Riverside Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Bayonne, NJ
National Provider Identifier
1063959211
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
OPTUM MEDICAL CARE OF NEW JERSEY PC
Doing business as
Riverside Medical Group
Practice address
544 Broadway
Bayonne, NJ 07002
Phone
(551) 257-7038
Fax
(201) 552-2358
NPI assigned
Jan 26, 2017
Last updated
Jun 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Authorized official

Name
Gaurang Ravaji Brahmbhatt, MDNPI 1225204266
Title
Cmo
Phone
(201) 706-8490

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

544 Broadway
Bayonne, NJ 07002

Mailing address

1 Harmon PLZ FL 10
Secaucus, NJ 07094-2803
Phone (763) 349-6825

Other names 1

  • Riverside Medical Group Doing business as

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20099/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/17375/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1063959211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HARMON PLZ FL 10",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070942803",
            "telephone_number": "763-349-6825",
            "fax_number": "877-828-9907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "07002",
            "telephone_number": "551-257-7038",
            "fax_number": "201-552-2358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM MEDICAL CARE OF NEW JERSEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-26",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "BRAHMBHATT",
        "authorized_official_first_name": "GAURANG",
        "authorized_official_middle_name": "RAVAJI",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "201-706-8490",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Riverside Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.