NPIMap

Organization Active NPI

Partners in Freedom LLC

  • Internal Medicine Physician
  • Wall Township, NJ
National Provider Identifier
1114978939
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PARTNERS IN FREEDOM LLC
Practice address
3350 Hwy 138 Ste 217
Wall Township, NJ 07719-9694
Phone
(732) 974-1980
Fax
(732) 681-0835
NPI assigned
May 15, 2006
Last updated
Feb 13, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
PARTNERS IN FREEDOM LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Authorized official

Name
Dr. Janice Siciliano, DONPI 1689612129
Title
Official Delegate/President
Phone
(732) 974-1980

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NJ
Internal Medicine Physician 207R00000X NJ Primary

Addresses

Primary practice location

3350 Hwy 138 Ste 217
Wall Township, NJ 07719-9694

Mailing address

3350 Hwy 138 Ste 217
Wall Township, NJ 07719-9694
Phone (732) 974-1980

Other identifiers 6

IdentifierTypeStateIssuer
0034835MedicaidNJ
5599107OtherNJGHI
60004140OtherNJHORIZON NJ HEALTH
2296455002OtherNJAMERIHEALTH HOWELL LOCATI
2296455001OtherNJAMERIHEALTH SEA GIRT LOCA
DB7403OtherNJRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040707000371 NJ Part B Supplier - Clinic/Group Practice 1254318256 Receives reassigned benefits from 3 practitioners
Practice locations: Wall Township, NJ

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
31D0886851Partners in Freedom LLC3350 Hwy 138 Suite 217, Wall, NJ 07719Certificate of waiverApr 18, 2027

National Provider Directory

National Provider Directory
Tax ID family
Partners in Freedom L L C4 organizations share this tax ID, including this one
Part of
Partners in Freedom L L C

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

500 Candlewood Cmns
Ste 5
Howell, NJ 07731
Phone (732) 364-1400

2130 Highway 35
Ste 324
Sea Girt, NJ 08750
Phone (732) 449-0063

Interoperability endpoints

  • Direct secure messaging: amandacody@pfllc.allscriptsdirect.net
  • Direct secure messaging: annadonaldson@pfllc.allscriptsdirect.net
  • Direct secure messaging: anne-mariemercadante@pfllc.allscriptsdirect.net
  • Direct secure messaging: deattegettinger@pfllc.allscriptsdirect.net
  • Direct secure messaging: donaldmicallef@pfllc.allscriptsdirect.net
  • Direct secure messaging: janicesiciliano@pfllc.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676246400000",
    "number": "1114978939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 HWY 138 STE 217",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077199694",
            "telephone_number": "732-974-1980",
            "fax_number": "732-681-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 HWY 138 STE 217",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077199694",
            "telephone_number": "732-974-1980",
            "fax_number": "732-681-0835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARTNERS IN FREEDOM LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARTNERS IN FREEDOM LLC",
        "enumeration_date": "2006-05-15",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A",
        "authorized_official_last_name": "SICILIANO",
        "authorized_official_first_name": "JANICE",
        "authorized_official_title_or_position": "OFFICIAL DELEGATE/PRESIDENT",
        "authorized_official_telephone_number": "732-974-1980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0034835",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "5599107",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "60004140",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH HOWELL LOCATI",
            "identifier": "2296455002",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH SEA GIRT LOCA",
            "identifier": "2296455001",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB7403",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wall Township, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.