NPIMap

Organization Active NPI

Neptune Adult Medicine LLC

  • Clinic/Center
  • Neptune, NJ
National Provider Identifier
1144476771
Registry record updated Mar 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
MA079626 Issued in NJ
Legal business name
NEPTUNE ADULT MEDICINE LLC
Practice address
1812 Corlies Avenue
Neptune, NJ 07753
Phone
(732) 988-3336
Fax
(732) 776-8668
NPI assigned
Aug 14, 2008
Last updated
Mar 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2009

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

Authorized official

Name
Dr. Kimberly Atienza, MDNPI 1881653848
Title
Physician
Phone
(732) 988-3336

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
Clinic/Center 261Q00000X MA079626 NJ Primary
Primary Care Clinic/Center 261QP2300X MA079626 NJ

Addresses

Primary practice location

1812 Corlies Avenue
Neptune, NJ 07753

Mailing address

1812 Corlies Avenue
Neptune, NJ 07753
Phone (732) 988-3336

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110922000438 NJ Part B Supplier - Clinic/Group Practice 6002087053 Receives reassigned benefits from 2 practitioners
Practice locations: Neptune, NJ

National Provider Directory

National Provider Directory

Locations

1812 State Route 33
Neptune, NJ 07753
Phone (732) 988-3336

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11042/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

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": "1218672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237420800000",
    "number": "1144476771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 CORLIES AVENUE",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-988-3336",
            "fax_number": "732-776-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 CORLIES AVENUE",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "07753",
            "telephone_number": "732-988-3336",
            "fax_number": "732-776-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPTUNE ADULT MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-14",
        "last_updated": "2009-03-19",
        "status": "A",
        "authorized_official_last_name": "ATIENZA",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "732-988-3336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NJ",
            "license": "MA079626",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NJ",
            "license": "MA079626",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neptune, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2009; 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.