Sovereign Medical Group, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SOVEREIGN MEDICAL GROUP, LLC

Practice address

630 Broad St
Suite 2B
Carlstadt, NJ 07072-1169

Phone

(201) 355-1700

NPI assigned

Oct 8, 2015

Last updated

Oct 8, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Hajjar, M.D.

Title

Owner

Phone

(201) 855-8302

Specialties & licenses 1

Addresses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HFFCCA

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444262400000",
    "number": "1073984654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 HARRISTOWN RD",
            "address_2": "2ND FLOOR",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074523329",
            "telephone_number": "201-855-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 BROAD ST",
            "address_2": "SUITE 2B",
            "city": "CARLSTADT",
            "state": "NJ",
            "postal_code": "070721169",
            "telephone_number": "201-355-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-08",
        "last_updated": "2015-10-08",
        "status": "A",
        "authorized_official_last_name": "HAJJAR",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-855-8302",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerolos Samy, RPH
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• Surgicare Surgical Associates of Carlstadt, LLC
• Elzbieta Szymanowska
• Transcend Surgery Center LLC

• Durable Medical Equipment & Medical Supplies in Carlstadt, NJ
• Providers in Carlstadt, NJ by specialty
• Durable Medical Equipment & Medical Supplies in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.