Organization Active NPI

Bandfish Emergency Physicians LLC

  • Hospitalist Physician
  • Montclair, NJ
National Provider Identifier
1174911325
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
BANDFISH EMERGENCY PHYSICIANS LLC
Practice address
1 Bay Ave
Montclair, NJ 07042-4837
Phone
(469) 401-2386
NPI assigned
Dec 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Authorized official

Name
Ross Ronan
Title
Vice President
Phone
(469) 401-2386

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1 Bay Ave
Montclair, NJ 07042-4837

Mailing address

13737 Noel Rd
Ste 1600
Dallas, TX 75240-1331
Phone (469) 401-2386

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444780800000",
    "number": "1174911325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13737 NOEL RD",
            "address_2": "STE 1600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752401331",
            "telephone_number": "469-401-2386",
            "fax_number": "214-712-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAY AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424837",
            "telephone_number": "469-401-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANDFISH EMERGENCY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-22",
        "last_updated": "2015-10-14",
        "status": "A",
        "authorized_official_last_name": "RONAN",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "469-401-2386"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; 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.