NPIMap

Organization Active NPI

Internal Medicine Faculty Practice Associates at St Barnabas Med Ctr

  • Internal Medicine Physician
  • West Orange, NJ
National Provider Identifier
1114975257
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INTERNAL MEDICINE FACULTY PRACTICE ASSOCIATES AT ST BARNABAS MED CTR
Practice address
101 Old Short Hills Rd
Suite 210
West Orange, NJ 07052-1000
Phone
(973) 322-6256
Fax
(973) 322-6241
NPI assigned
May 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Authorized official

Name
Mr. Patrick Ahearn
Title
Director
Phone
(732) 557-7119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

101 Old Short Hills Rd
Suite 210
West Orange, NJ 07052-1000

Mailing address

PO Box 18313
Newark, NJ 07191-8313
Phone (732) 557-7160

Other identifiers 1

IdentifierTypeStateIssuer
6462901MedicaidNJ

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
31D0652872Internal Medicine Faculty Practice101 Old Short Hills Rd, West Orange, NJ 07052Certificate of waiverApr 5, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1114975257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18313",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071918313",
            "telephone_number": "732-557-7160",
            "fax_number": "732-557-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 OLD SHORT HILLS RD",
            "address_2": "SUITE 210",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521000",
            "telephone_number": "973-322-6256",
            "fax_number": "973-322-6241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE FACULTY PRACTICE ASSOCIATES AT ST BARNABAS MED CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "AHEARN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-557-7119",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6462901",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.