Stat Portable X-Ray of New Jersey, LLC

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

STAT PORTABLE X-RAY OF NEW JERSEY, LLC

Practice address

160 Durham Ave Ste 101
Metuchen, NJ 08840-1261

Phone

(201) 440-1757

NPI assigned

Dec 24, 2018

Organization subpart

No

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

Authorized official

Name

Menachem Leder

Title

Operations Manager

Phone

(718) 217-8000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

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

{
    "created_epoch": "1545609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661904000000",
    "number": "1174095582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21118 UNION TPKE",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113643241",
            "telephone_number": "718-217-8000",
            "fax_number": "718-217-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 DURHAM AVE STE 101",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088401261",
            "telephone_number": "201-440-1757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAT PORTABLE X-RAY OF NEW JERSEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-24",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A",
        "authorized_official_last_name": "LEDER",
        "authorized_official_first_name": "MENACHEM",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "718-217-8000"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Stat Portable X-Ray of New Jersey, LLC
• Jaunai Staton
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• Wayne E Steinbeck, MD
• Deana Nicole Stevens, PSY.D.
• Edward Carl Stivers, D.C., C.C.S.P.

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Metuchen, NJ
• Providers in Metuchen, NJ by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.