Organization Active NPI

Shore Cardiac Center LLC

  • Cardiovascular Disease Physician
  • Toms River, NJ
National Provider Identifier
1104210418
Registry record updated Jan 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
25MA09530100 Issued in NJ
Legal business name
SHORE CARDIAC CENTER LLC
Practice address
651 Route 37 W
Toms River, NJ 08755-8060
Phone
(732) 286-6103
Fax
(732) 518-5252
NPI assigned
Mar 25, 2015
Last updated
Jan 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2016

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

Authorized official

Name
Dr. Bhavna Mohandas, MD, FACC
Title
Owner
Phone
(732) 330-2566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 25MA09530100 NJ Primary

Addresses

Primary practice location

651 Route 37 W
Toms River, NJ 08755-8060

Mailing address

651 Route 37 W
Toms River, NJ 08755-8060
Phone (732) 286-6103

Other identifiers 1

IdentifierTypeStateIssuer
0061697MedicaidNJ

National Provider Directory

National Provider Directory

Locations

9 Hospital Dr
Ste C2
Toms River, NJ 08755
Phone (732) 240-6688

NPI Registry JSON

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452038400000",
    "number": "1104210418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 ROUTE 37 W",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087558060",
            "telephone_number": "732-286-6103",
            "fax_number": "732-518-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 ROUTE 37 W",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087558060",
            "telephone_number": "732-286-6103",
            "fax_number": "732-518-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE CARDIAC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-25",
        "last_updated": "2016-01-06",
        "status": "A",
        "authorized_official_last_name": "MOHANDAS",
        "authorized_official_first_name": "BHAVNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-330-2566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, FACC"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MA09530100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0061697",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; 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.