NPIMap

Organization Active NPI

Primary Care Partners, LLC

Doing business as Montclair Pediatric Group

  • Pediatrics Physician
  • Montclair, NJ
National Provider Identifier
1174911747
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PRIMARY CARE PARTNERS, LLC
Doing business as
Montclair Pediatric Group
Practice address
73 Park St
Montclair, NJ 07042-2903
Phone
(973) 746-7375
Fax
(973) 746-6772
NPI assigned
Jan 5, 2015
Last updated
Jan 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Authorized official

Name
Dr. David Shulkin, MD
Title
President
Phone
(856) 782-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

73 Park St
Montclair, NJ 07042-2903

Mailing address

PO Box 2403
Voorhees, NJ 08043-6403
Phone (856) 782-3300

Other names 1

  • Montclair Pediatric Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Primary Care Partners LLC44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420416000000",
    "number": "1174911747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2403",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080436403",
            "telephone_number": "856-782-3300",
            "fax_number": "856-504-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 PARK ST",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070422903",
            "telephone_number": "973-746-7375",
            "fax_number": "973-746-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-01-05",
        "status": "A",
        "authorized_official_last_name": "SHULKIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-782-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montclair Pediatric Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 5, 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.