Organization Active NPI

Center for Primary Care Medicine LLC

  • Internal Medicine Physician
  • Princeton Junction, NJ
National Provider Identifier
1194997304
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CENTER FOR PRIMARY CARE MEDICINE LLC
Practice address
4065 Quakerbridge Rd
Princeton Junction, NJ 08550-5243
Phone
(609) 436-5900
Fax
(609) 452-0222
NPI assigned
Mar 27, 2008
Last updated
Jun 21, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Authorized official

Name
Bonnie L Hartz
Title
Administrative Assistant
Phone
(609) 436-5900

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Cardiovascular Disease Physician 207RC0000X NU
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X NU
Diagnostic Ultrasound Physician 2085U0001X NU

Addresses

Primary practice location

4065 Quakerbridge Rd
Princeton Junction, NJ 08550-5243

Mailing address

4065 Quakerbridge Rd
Princeton Junction, NJ 08550-5243
Phone (609) 436-5900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080610000470 NJ Part B Supplier - Clinic/Group Practice 3476623935 Receives reassigned benefits from 3 practitioners
Practice locations: Princeton, NJ

National Provider Directory

National Provider Directory

Locations

601 Ewing St
Ste A8
Princeton, NJ 08540
Phone (609) 436-5900

Practitioners & affiliated clinicians

Practitioners 6

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": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340236800000",
    "number": "1194997304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4065 QUAKERBRIDGE RD",
            "city": "PRINCETON JUNCTION",
            "state": "NJ",
            "postal_code": "085505243",
            "telephone_number": "609-436-5900",
            "fax_number": "609-452-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4065 QUAKERBRIDGE RD",
            "city": "PRINCETON JUNCTION",
            "state": "NJ",
            "postal_code": "085505243",
            "telephone_number": "609-436-5900",
            "fax_number": "609-452-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PRIMARY CARE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-27",
        "last_updated": "2012-06-21",
        "status": "A",
        "authorized_official_last_name": "HARTZ",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "609-436-5900"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton Junction, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.