NPIMap

Organization Active NPI

Princeton Brain & Spine, LLC

  • Durable Medical Equipment & Medical Supplies
  • Freehold, NJ
National Provider Identifier
1134741010
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PRINCETON BRAIN & SPINE, LLC
Practice address
901 W Main St Ste 267
Freehold, NJ 07728-2537
Phone
(609) 921-9001
NPI assigned
May 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Authorized official

Name
Mark McLaughlin, MD
Title
Authorized Official
Phone
(609) 921-9001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

901 W Main St Ste 267
Freehold, NJ 07728-2537

Mailing address

901 W Main St Ste 267
Freehold, NJ 07728-2537
Phone (609) 921-9001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200519000218 NJ DME Supplier - Physician - NeurosurgeryDME Supplier - Physician - Orthopedic/Orthopedic Surgery 8224075510 Practice locations: Freehold, NJ

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1134741010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST STE 267",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537",
            "telephone_number": "609-921-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W MAIN ST STE 267",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282537",
            "telephone_number": "609-921-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON BRAIN & SPINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-13",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "MCLAUGHLIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "609-921-9001",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.