Organization Active NPI

TR Medical Group LLC

  • Internal Medicine Physician
  • Wayne, NJ
National Provider Identifier
1164743993
Registry record updated Jun 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA08496800 Issued in NJ
Legal business name
TR MEDICAL GROUP LLC
Practice address
504 Hamburg Tpke
Suite 202
Wayne, NJ 07470-2034
Phone
(973) 956-1459
Fax
(973) 956-1473
NPI assigned
Jun 16, 2010
Last updated
Jun 16, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2010

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

Authorized official

Name
Dr. Tarek Refaie, M.D.NPI 1093917874
Title
Owner/Physician
Phone
(551) 208-0331

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA08496800 NJ Primary

Addresses

Primary practice location

504 Hamburg Tpke
Suite 202
Wayne, NJ 07470-2034

Mailing address

504 Hamburg Tpke
Suite 202
Wayne, NJ 07470-2034
Phone (973) 956-1459

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100929000085 NJ Part B Supplier - Clinic/Group Practice 5799801601 Receives reassigned benefits from 1 practitioner
Practice locations: Wayne, NJ

National Provider Directory

National Provider Directory

Locations

504 Hamburg Tpke
Ste 202
Wayne, NJ 07470
Phone (551) 208-0331

Practitioners & affiliated clinicians

Practitioners 1

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": "1276646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276646400000",
    "number": "1164743993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 HAMBURG TPKE",
            "address_2": "SUITE 202",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702034",
            "telephone_number": "973-956-1459",
            "fax_number": "973-956-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 HAMBURG TPKE",
            "address_2": "SUITE 202",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702034",
            "telephone_number": "973-956-1459",
            "fax_number": "973-956-1473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TR MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-16",
        "last_updated": "2010-06-16",
        "status": "A",
        "authorized_official_last_name": "REFAIE",
        "authorized_official_first_name": "TAREK",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "551-208-0331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA08496800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; 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.