Individual provider Active NPI

Richard J Degroote II, M.D.

  • Pediatrics Physician
  • Long Branch, NJ
National Provider Identifier
1104875947
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA03004300 Issued in NJ
Practice address
300 2ND Ave
Long Branch, NJ 07740-6303
Phone
(732) 923-7100
Fax
(732) 923-7104
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA03004300 NJ Primary

Addresses

Primary practice location

300 2ND Ave
Long Branch, NJ 07740-6303

Mailing address

PO Box 8000
Dept 601
Buffalo, NY 14267-0002
Phone (866) 295-0041

Other identifiers 1

IdentifierTypeStateIssuer
1859102MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group, PC PastSince Jan 15, 2007 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1104875947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8000",
            "address_2": "DEPT 601",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142670002",
            "telephone_number": "866-295-0041",
            "fax_number": "708-342-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 2ND AVE",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077406303",
            "telephone_number": "732-923-7100",
            "fax_number": "732-923-7104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGROOTE",
        "first_name": "RICHARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA03004300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1859102",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Branch, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.