Organization Active NPI

Thomas Scuderi MD,PA

  • Primary Care Clinic/Center
  • Hazlet, NJ
National Provider Identifier
1154583904
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
MA02982800 Issued in NJ
Legal business name
THOMAS SCUDERI MD,PA
Practice address
80 Hazlet Ave
Suite 10
Hazlet, NJ 07730-1623
Phone
(732) 264-0400
Fax
(732) 264-1149
NPI assigned
Jul 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Authorized official

Name
Thomas Scuderi, MD
Title
Owner
Phone
(732) 264-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X MA02982800 NJ Primary

Addresses

Primary practice location

80 Hazlet Ave
Suite 10
Hazlet, NJ 07730-1623

Mailing address

80 Hazlet Ave
Suite 10
Hazlet, NJ 07730-1623
Phone (732) 264-0400

Other identifiers 1

IdentifierTypeStateIssuer
2947609MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1154583904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 HAZLET AVE",
            "address_2": "SUITE 10",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301623",
            "telephone_number": "732-264-0400",
            "fax_number": "732-264-1149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HAZLET AVE",
            "address_2": "SUITE 10",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301623",
            "telephone_number": "732-264-0400",
            "fax_number": "732-264-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS SCUDERI MD,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "SCUDERI",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-264-0400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NJ",
            "license": "MA02982800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2947609",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazlet, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; 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.