Organization Active NPI

Pediatric Neurosurgeons of New Jersey, PC

  • Neurological Surgery Physician
  • Maywood, NJ
National Provider Identifier
1194509356
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
PEDIATRIC NEUROSURGEONS OF NEW JERSEY, PC
Practice address
13 Essex St Ste 204
Maywood, NJ 07607-1806
Phone
(551) 777-8118
Fax
(551) 310-0615
NPI assigned
Aug 21, 2023
Last updated
Aug 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Authorized official

Name
Dr. Timothy W Vogel, MDNPI 1548471907
Title
President
Phone
(201) 525-8701

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

13 Essex St Ste 204
Maywood, NJ 07607-1806

Mailing address

134 Orangeburgh Rd
Old Tappan, NJ 07675-7499
Phone (551) 777-8118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250604000034 NJ Part B Supplier - Clinic/Group Practice 2860901535 Receives reassigned benefits from 1 practitioner
Practice locations: Clifton, NJ

National Provider Directory

National Provider Directory

Locations

1117 US Highway 46
Ste 202
Clifton, NJ 07013
Phone (973) 778-8728

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1194509356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 ORANGEBURGH RD",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076757499",
            "telephone_number": "551-777-8118",
            "fax_number": "551-310-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 ESSEX ST STE 204",
            "city": "MAYWOOD",
            "state": "NJ",
            "postal_code": "076071806",
            "telephone_number": "551-777-8118",
            "fax_number": "551-310-0615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC NEUROSURGEONS OF NEW JERSEY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "VOGEL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-525-8701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.