Individual provider Active NPI

Cheryl E Caudill, PA-C

  • Physician Assistant
  • Wall Township, NJ
National Provider Identifier
1164725743
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00357400 Issued in NJ
Practice address
4810 Belmar Blvd
Wall Township, NJ 07753-6952
Phone
(732) 938-6090
Fax
(732) 938-5680
NPI assigned
Dec 21, 2010
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1094917 FL
Physician Assistant 363A00000X 25MP00357400 NJ Primary
Surgical Physician Assistant 363AS0400X 25MP00357400 NJ

Addresses

Primary practice location

4810 Belmar Blvd
Wall Township, NJ 07753-6952

Mailing address

331 Newman Springs Rd Ste 220
Red Bank, NJ 07701-5792
Phone (732) 807-0877

Other practice location 1

1945 State Rte 33
Ackerman
Neptune, NJ 07753-4859
Phone (732) 776-4135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150320000168 NJ Practitioner - Physician Assistant 5799967139 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1094917FLMDPhysician Assistant
25MP00357400NJMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Dec 2, 2024 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Dec 2, 2024 Accepting new patients
Orthonj LLC CurrentSince Jan 1, 2021 Accepting new patients
Orthonj LLC CurrentSince Jan 1, 2021 Accepting new patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients
Peter R Aldana MD PA Past Accepting new patients

Locations

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

2315 Route 34
Manasquan, NJ 08736
Phone (732) 974-0404

1944 State Route 33
Neptune, NJ 07753
Phone (732) 776-3787

5 Plainsboro Rd
Ste 100
Plainsboro, NJ 08536
Phone (609) 750-1600

331 Newman Springs Rd
Ste 220
Red Bank, NJ 07701
Phone (732) 807-0880

2 Worlds Fair Dr
Somerset, NJ 08873
Phone (732) 537-0200

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

4810 Belmar Blvd
Wall Township, NJ 07753
Phone (732) 938-5333

4810 Belmar Blvd
Fl 1
Wall Township, NJ 07753
Phone (732) 774-3880

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1292889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1164725743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 NEWMAN SPRINGS RD STE 220",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015792",
            "telephone_number": "732-807-0877",
            "fax_number": "201-751-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 BELMAR BLVD",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077536952",
            "telephone_number": "732-938-6090",
            "fax_number": "732-938-5680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1945 State Rte 33",
            "address_2": "Ackerman",
            "address_purpose": "LOCATION",
            "city": "Neptune",
            "state": "NJ",
            "postal_code": "077534859",
            "country_code": "US",
            "telephone_number": "732-776-4135",
            "fax_number": "732-776-4836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAUDILL",
        "first_name": "CHERYL",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-21",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA1094917",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00357400",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00357400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wall Township, NJ

Sources for this page

Verify at the official NPI Registry.