Organization Active NPI

North Jersey Medical Group

  • Specialist
  • Paterson, NJ
National Provider Identifier
1174732069
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA38759 Issued in NJ
Legal business name
NORTH JERSEY MEDICAL GROUP
Practice address
715 Broadway
Paterson, NJ 07514-3406
Phone
(973) 684-8617
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
Ashoke Agarwal, MD
Title
Owner
Phone
(973) 684-8617

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MA38759 NJ Primary

Addresses

Primary practice location

715 Broadway
Paterson, NJ 07514-3406

Mailing address

715 Broadway
Paterson, NJ 07514-3406
Phone (973) 684-8617

Other identifiers 3

IdentifierTypeStateIssuer
1119516OtherNJHORIZON NJ HEALTH
2497031OtherAETNA
8430306MedicaidNJ

National Provider Directory

National Provider Directory

Locations

715 Broadway
Ste 1
Paterson, NJ 07514
Phone (973) 684-8617

680 Broadway
Ste 116B
Paterson, NJ 07514
Phone (973) 684-8617

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1174732069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 BROADWAY",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075143406",
            "telephone_number": "973-684-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 BROADWAY",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075143406",
            "telephone_number": "973-684-8617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH JERSEY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "AGARWAL",
        "authorized_official_first_name": "ASHOKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-684-8617",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA38759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1119516",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2497031",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8430306",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.