Organization Active NPI

Jean M Augustin MD PA

  • Internal Medicine Physician
  • Newark, NJ
National Provider Identifier
1124331814
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA02435600 Issued in NJ
Legal business name
JEAN M AUGUSTIN MD PA
Practice address
850 S 11TH St
Newark, NJ 07108-1304
Phone
(973) 373-6066
Fax
(973) 824-7960
NPI assigned
Jul 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Authorized official

Name
John M Augustin, MD
Title
President
Phone
(973) 373-6066

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 25MA02435600 NJ Primary

Addresses

Primary practice location

850 S 11TH St
Newark, NJ 07108-1304

Mailing address

850 S 11TH St
Newark, NJ 07108-1304
Phone (973) 373-6066

National Provider Directory

National Provider Directory

Locations

850 S 11th St
Newark, NJ 07108
Phone (973) 373-6066

NPI Registry JSON

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279756800000",
    "number": "1124331814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 S 11TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071081304",
            "telephone_number": "973-373-6066",
            "fax_number": "973-824-7960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S 11TH ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071081304",
            "telephone_number": "973-373-6066",
            "fax_number": "973-824-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEAN M AUGUSTIN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-07-22",
        "status": "A",
        "authorized_official_last_name": "AUGUSTIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-373-6066",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA02435600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; 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.