Organization Active NPI

Jersey Shore Medical and Pediatrics Associates,LLC

  • Adolescent Medicine (Internal Medicine) Physician
  • Lakewood, NJ
National Provider Identifier
1073642401
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X
License
MA070826 Issued in NJ
Legal business name
JERSEY SHORE MEDICAL AND PEDIATRICS ASSOCIATES,LLC
Practice address
1215 Highway 70
Suite 1005
Lakewood, NJ 08701-5947
Phone
(732) 942-0888
Fax
(732) 942-1230
NPI assigned
Mar 2, 2007
Last updated
Feb 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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

Authorized official

Name
Dr. Randy Pablo Talamayan, MD
Title
President
Phone
(732) 942-0888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X MA070826 NJ Primary

Addresses

Primary practice location

1215 Highway 70
Suite 1005
Lakewood, NJ 08701-5947

Mailing address

1215 Highway 70
Suite 1005
Lakewood, NJ 08701-5947
Phone (732) 942-0888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050517000739 NJ Part B Supplier - Clinic/Group Practice 6507807898 Receives reassigned benefits from 6 practitioners
Practice locations: Lakewood, NJ

National Provider Directory

National Provider Directory

Locations

1215 Route 70
Ste 1005
Lakewood, NJ 08701
Phone (732) 905-0077

1255 Route 70
Ste 12N
Lakewood, NJ 08701
Phone (732) 942-0888

Practitioners & affiliated clinicians

Practitioners 6

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": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266451200000",
    "number": "1073642401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 HIGHWAY 70",
            "address_2": "SUITE 1005",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015947",
            "telephone_number": "732-942-0888",
            "fax_number": "732-942-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 HIGHWAY 70",
            "address_2": "SUITE 1005",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015947",
            "telephone_number": "732-942-0888",
            "fax_number": "732-942-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY SHORE MEDICAL AND PEDIATRICS ASSOCIATES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2010-02-18",
        "status": "A",
        "authorized_official_last_name": "TALAMAYAN",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "PABLO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-942-0888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "NJ",
            "license": "MA070826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.