Progressive Care Medical Group of NJ, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

PROGRESSIVE CARE MEDICAL GROUP OF NJ, LLC

Practice address

29 Oriole Way
Moorestown, NJ 08057-1335

Phone

(516) 855-5255

NPI assigned

Nov 28, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Deepak Rameshchandra Patel, MD

Title

Owner/Authorized Official

Phone

(845) 339-5100

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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

• Jonathan Wiesen, M.D.

  • Internal Medicine Physician
  • Norfolk, VA
  • NPI 1912149006

  NJ

  Medicare reassignment

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661731200000",
    "number": "1124532270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 EILEEN WAY UNIT 1",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117915313",
            "telephone_number": "516-855-5255",
            "fax_number": "516-921-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 ORIOLE WAY",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080571335",
            "telephone_number": "516-855-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE CARE MEDICAL GROUP OF NJ, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-28",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "DEEPAK",
        "authorized_official_middle_name": "RAMESHCHANDRA",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "845-339-5100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Marie Presner, BCBA
• Cheryl C. Pride I, MSW, LCSW
• Primary Care of Moorestown PC
• Princeton Medical Center
• Private Duty Services of Partners in Home Care Inc.
• Promedica Senior Care of Moorestown NJ, LLC
• Jennifer Pugliese, LCSW
• Sergio H. Pulido, DO
• Wyndham Pursley, CRNP
• Daniel P Putnam, M.D.

• Physical Medicine & Rehabilitation Physician in Moorestown, NJ
• Providers in Moorestown, NJ by specialty
• Physical Medicine & Rehabilitation Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.