NPIMap

Organization Active NPI

US Medgroup of New Jersey PA

Doing business as Concentra Advanced Specialist

  • Multi-Specialty Clinic/Center
  • Glen Burnie, MD
National Provider Identifier
1194155127
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
US MEDGROUP OF NEW JERSEY PA
Doing business as
Concentra Advanced Specialist
Practice address
811 Cromwell Park Dr
Ste. 104 -105
Glen Burnie, MD 21061-2566
Phone
(410) 553-0110
NPI assigned
Nov 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Authorized official

Name
Robert Hassett, DO
Title
President
Phone
(972) 364-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

811 Cromwell Park Dr
Ste. 104 -105
Glen Burnie, MD 21061-2566

Mailing address

5080 Spectrum Dr
Suite 1200 West Tower
Addison, TX 75001-4648

Other names 1

  • Concentra Advanced Specialist Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Concentra Advanced Specialist4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435622400000",
    "number": "1194155127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DR",
            "address_2": "SUITE 1200 WEST TOWER",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 CROMWELL PARK DR",
            "address_2": "STE. 104 -105",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210612566",
            "telephone_number": "410-553-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "US MEDGROUP OF NEW JERSEY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-12",
        "last_updated": "2015-06-30",
        "status": "A",
        "authorized_official_last_name": "HASSETT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-364-8000",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concentra Advanced Specialist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.