NPIMap

Organization Active NPI

Jersey Shore Internal Medicine and Family Practice Associates PC

  • Internal Medicine Physician
  • Eatontown, NJ
National Provider Identifier
1164488003
Registry record updated Mar 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
JERSEY SHORE INTERNAL MEDICINE AND FAMILY PRACTICE ASSOCIATES PC
Practice address
2-12 Corbett Way
Ste. 102
Eatontown, NJ 07724-4251
Phone
(732) 263-7965
Fax
(732) 263-7962
NPI assigned
Apr 20, 2006
Last updated
Mar 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2013

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

Authorized official

Name
Carl Marchetti, M.D.
Title
Director
Phone
(732) 643-4312

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NJ
Internal Medicine Physician 207R00000X NJ Primary

Addresses

Primary practice location

2-12 Corbett Way
Ste. 102
Eatontown, NJ 07724-4251

Mailing address

2-12 Corbett Way
Ste. 102
Eatontown, NJ 07724-4251
Phone (732) 263-7965

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364169600000",
    "number": "1164488003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2-12 CORBETT WAY",
            "address_2": "STE. 102",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077244251",
            "telephone_number": "732-263-7965",
            "fax_number": "732-263-7962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2-12 CORBETT WAY",
            "address_2": "STE. 102",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077244251",
            "telephone_number": "732-263-7965",
            "fax_number": "732-263-7962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY SHORE INTERNAL MEDICINE AND FAMILY PRACTICE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2013-03-25",
        "status": "A",
        "authorized_official_last_name": "MARCHETTI",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-643-4312",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatontown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2013; 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.