NPIMap

Organization Active NPI

Vanguard Medical Group, PA

  • Family Medicine Physician
  • Verona, NJ
National Provider Identifier
1073674412
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VANGUARD MEDICAL GROUP, PA
Practice address
271 Grove Ave
Suite a
Verona, NJ 07044-1730
Phone
(973) 239-2600
Fax
(833) 495-1921
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Authorized official

Name
Ronisha Katrina Scales
Title
Credentialing Specialist
Phone
(973) 559-3700

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X

Addresses

Primary practice location

271 Grove Ave
Suite a
Verona, NJ 07044-1730

Mailing address

271 Grove Ave Ste E
Verona, NJ 07044-1730
Phone (973) 559-3700

Other practice location 1

477 Route 10 E Ste 301
Randolph, NJ 07869-2142
Phone (973) 560-9500

Other practice location 2

72 Hamburg Tpke Ste B
Riverdale, NJ 07457-1158
Phone (973) 696-6687

Other practice location 3

43 Main St
Farmingdale, NJ 07727-1340
Phone (732) 938-6471

Other practice location 4

570 South Ave E Unit A
Cranford, NJ 07016-3200
Phone (908) 272-7990

Other practice location 5

466 Old Hook Rd
Emerson, NJ 07630-1396
Phone (201) 649-8100

Other practice location 6

127 Montgomery St
Jersey City, NJ 07302-3616
Phone (201) 431-7200

Other practice location 7

16 Pocono Rd Ste 310
Denville, NJ 07834-2908
Phone (973) 627-7570

Other practice location 8

200 Highland Ave Ste 100B
Glen Ridge, NJ 07028-1521
Phone (973) 969-3800

Other practice location 9

825 Bloomfield Ave Ste Ll1
Verona, NJ 07044-1300
Phone (973) 233-4493

Other practice location 10

1114 Goffle Rd Ste 104
Hawthorne, NJ 07506-2014
Phone (973) 969-3800

Other names 1

  • Town Medical Associates, P.A. Former legal business name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050701000022 NJ Part B Supplier - Clinic/Group Practice 5092751842 Receives reassigned benefits from 61 practitioners
Practice locations: Farmingdale, NJ; Verona, NJ; Riverdale, NJ; Randolph, NJ; Jersey City, NJ; Hawthorne, NJ; Glen Ridge, NJ; Emerson, NJ…
O20140102000327 NJ DME Supplier - Physician - General PracticeDME Supplier - Sports Medicine 5092751842 Practice locations: Verona, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0939851Vanguard Medical Group1114 Goffle Rd, Hawthorne, NJ 07506Certificate of waiverAug 13, 2026
31D0978558Vanguard Medical Group43 Main Street, Farmingdale, NJ 07727Certificate of waiverSep 26, 2026
31D2114541Vanguard Medical Group at Riverdale72 Hamburg Turnpike, Riverdale, NJ 07457Certificate of waiverJun 15, 2028
31D2114734Vanguard Medical Group at Jersey City127 Montgomery Street, Jersey City, NJ 07302Certificate of waiverJun 20, 2028
31D2131577Vanguard Medical Group, PA477 Route 10, Suite 205, Randolph, NJ 07869Certificate of waiverMay 31, 2027
31D2139216Vanguard Medical Group, PA200 Highland Avenue, Suite 200 B, Glen Ridge, NJ 07028Certificate of waiverOct 30, 2027
31D2155829Vanguard Medical, PA16 Pocono Road, Denville, NJ 07834ComplianceJun 5, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

43 Main St
Ste 1
Farmingdale, NJ 07727
Phone (732) 938-6471

200 Highland Ave
Ste 100B
Glen Ridge, NJ 07028
Phone (973) 969-3800

858 S White Horse Pike
Unit B2
Hammonton, NJ 08037
Phone (609) 561-2345

1114 Goffle Rd
Ste 104
Hawthorne, NJ 07506
Phone (973) 636-9000

535 High Mountain Rd
Ste 111
North Haledon, NJ 07508
Phone (973) 305-8300

477 Route 10 E
Ste 301
Randolph, NJ 07869
Phone (973) 560-9500

271 Grove Ave
Ste E
Verona, NJ 07044
Phone (973) 559-3700

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 72

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

View all 72

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759881600000",
    "number": "1073674412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 GROVE AVE STE E",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441730",
            "telephone_number": "973-559-3700",
            "fax_number": "973-559-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 GROVE AVE",
            "address_2": "SUITE A",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441730",
            "telephone_number": "973-239-2600",
            "fax_number": "833-495-1921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "477 Route 10 E Ste 301",
            "address_purpose": "LOCATION",
            "city": "Randolph",
            "state": "NJ",
            "postal_code": "078692142",
            "country_code": "US",
            "telephone_number": "973-560-9500",
            "fax_number": "973-576-4650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "72 Hamburg Tpke Ste B",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "NJ",
            "postal_code": "074571158",
            "country_code": "US",
            "telephone_number": "973-696-6687",
            "fax_number": "833-488-1216",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "43 Main St",
            "address_purpose": "LOCATION",
            "city": "Farmingdale",
            "state": "NJ",
            "postal_code": "077271340",
            "country_code": "US",
            "telephone_number": "732-938-6471",
            "fax_number": "833-488-1209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "570 South Ave E Unit A",
            "address_purpose": "LOCATION",
            "city": "Cranford",
            "state": "NJ",
            "postal_code": "070163200",
            "country_code": "US",
            "telephone_number": "908-272-7990",
            "fax_number": "973-272-7970",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "466 Old Hook Rd",
            "address_purpose": "LOCATION",
            "city": "Emerson",
            "state": "NJ",
            "postal_code": "076301396",
            "country_code": "US",
            "telephone_number": "201-649-8100",
            "fax_number": "201-649-8101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "127 Montgomery St",
            "address_purpose": "LOCATION",
            "city": "Jersey City",
            "state": "NJ",
            "postal_code": "073023616",
            "country_code": "US",
            "telephone_number": "201-431-7200",
            "fax_number": "201-526-0474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16 Pocono Rd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Denville",
            "state": "NJ",
            "postal_code": "078342908",
            "country_code": "US",
            "telephone_number": "973-627-7570",
            "fax_number": "973-664-7572",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Highland Ave Ste 100B",
            "address_purpose": "LOCATION",
            "city": "Glen Ridge",
            "state": "NJ",
            "postal_code": "070281521",
            "country_code": "US",
            "telephone_number": "973-969-3800",
            "fax_number": "973-969-3232",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "825 Bloomfield Ave Ste Ll1",
            "address_purpose": "LOCATION",
            "city": "Verona",
            "state": "NJ",
            "postal_code": "070441300",
            "country_code": "US",
            "telephone_number": "973-233-4493",
            "fax_number": "833-484-1611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1114 Goffle Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Hawthorne",
            "state": "NJ",
            "postal_code": "075062014",
            "country_code": "US",
            "telephone_number": "973-969-3800",
            "fax_number": "833-493-1245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VANGUARD MEDICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A",
        "authorized_official_last_name": "SCALES",
        "authorized_official_first_name": "RONISHA",
        "authorized_official_middle_name": "KATRINA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "973-559-3700"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Town Medical Associates, P.A.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Town Medical Associates, P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Verona, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.