NPIMap

Organization Active NPI

Rutgers Health-RWJ Pediatric Critical Care

  • Pediatric Critical Care Medicine Physician
  • New Brunswick, NJ
National Provider Identifier
1164510400
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
Legal business name
RUTGERS HEALTH-RWJ PEDIATRIC CRITICAL CARE
Practice address
1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928
Phone
(732) 235-7900
Fax
(732) 235-9340
NPI assigned
Oct 11, 2006
Last updated
Nov 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Authorized official

Name
Nancy D Brady
Title
Sr Director of Revenue Cycle
Phone
(732) 235-6066

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X Primary

Addresses

Primary practice location

1 Robert Wood Johnson PL
New Brunswick, NJ 08901-1928

Mailing address

66 West Gilbert St
Red Bank, NJ 07701
Phone (732) 212-0051

Other identifiers 1

IdentifierTypeStateIssuer
6306900MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050119000070 NJ Part B Supplier - Clinic/Group Practice 1355390287 Receives reassigned benefits from 511 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Belleville, NJ; Toms River, NJ; Somerville, NJ; Somerset, NJ; Piscataway, NJ; New Brunswick, NJ; Manahawkin, NJ; Long Branch, NJ…

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

95 Rockafeller Rd
Piscataway, NJ 08854
Phone (516) 398-1733

Practitioners & affiliated clinicians

Practitioners 107

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.

View all 107

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572825600000",
    "number": "1164510400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 WEST GILBERT ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "07701",
            "telephone_number": "732-212-0051",
            "fax_number": "732-212-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROBERT WOOD JOHNSON PL",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928",
            "telephone_number": "732-235-7900",
            "fax_number": "732-235-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTGERS HEALTH-RWJ PEDIATRIC CRITICAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2019-11-04",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SR DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "732-235-6066"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6306900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.