NPIMap

Organization Active NPI

Jersey Shore Bethany Pediatrics

  • Pediatrics Physician
  • Hazlet, NJ
National Provider Identifier
1194781591
Registry record updated Mar 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
JERSEY SHORE BETHANY PEDIATRICS
Practice address
1 Bethany Rd
Building 5: Suite 65
Hazlet, NJ 07730-1663
Phone
(732) 264-0700
Fax
(732) 264-1414
NPI assigned
Apr 25, 2006
Last updated
Mar 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2009

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

Authorized official

Name
Carl Marchetti, M.D.
Title
Director
Phone
(732) 264-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NJ Primary

Addresses

Primary practice location

1 Bethany Rd
Building 5: Suite 65
Hazlet, NJ 07730-1663

Mailing address

PO Box 23674
Newark, NJ 07189-0001
Phone (732) 264-0700

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0114475Bethany Pediatrics1 Bethany Rd BLDG 5 Suite 65, Hazlet, NJ 07730Certificate of waiverApr 15, 2027

National Provider Directory

National Provider Directory

Locations

1 Bethany Rd
Ste 65
Hazlet, NJ 07730
Phone (732) 264-0700

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237766400000",
    "number": "1194781591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23674",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071890001",
            "telephone_number": "732-264-0700",
            "fax_number": "732-264-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BETHANY RD",
            "address_2": "BUILDING 5: SUITE 65",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301663",
            "telephone_number": "732-264-0700",
            "fax_number": "732-264-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY SHORE BETHANY PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-25",
        "last_updated": "2009-03-23",
        "status": "A",
        "authorized_official_last_name": "MARCHETTI",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "732-264-0700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazlet, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.