Active NPI
Richard J Degroote II, M.D.
- Pediatrics Physician
- Long Branch, NJ
National Provider Identifier
1104875947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 25MA03004300
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1859102 | Medicaid | NJ |
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barnabas Health Medical Group, PC | Past | 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.
-
- Specialist
- West Orange, NJ
- NPI 1447206420
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.