NPIMap

Organization Active NPI

Coastal Urology Associates PA

  • Urology Physician
  • Brick, NJ
National Provider Identifier
1215910286
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
COASTAL UROLOGY ASSOCIATES PA
Practice address
446 Jack Martin Blvd
Brick, NJ 08724-7733
Phone
(732) 840-4300
Fax
(732) 840-4515
NPI assigned
Nov 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

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

Authorized official

Name
Mr. Gary C Linn, MDNPI 1447233416
Title
Vice President
Phone
(732) 840-4300

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
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

446 Jack Martin Blvd
Brick, NJ 08724-7733

Mailing address

446 Jack Martin Blvd
Brick, NJ 08724-7733
Phone (732) 840-4300

Other identifiers 1

IdentifierTypeStateIssuer
2634503MedicaidNJ

National Provider Directory

National Provider Directory

Locations

224 Jack Martin Blvd
Ste E4
Brick, NJ 08724
Phone (484) 686-5343

814 River Ave
Ste B
Lakewood, NJ 08701
Phone (732) 370-2250

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327968000000",
    "number": "1215910286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 JACK MARTIN BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247733",
            "telephone_number": "732-840-4300",
            "fax_number": "732-840-4515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 JACK MARTIN BLVD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087247733",
            "telephone_number": "732-840-4300",
            "fax_number": "732-840-4515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL UROLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-23",
        "last_updated": "2012-01-31",
        "status": "A",
        "authorized_official_last_name": "LINN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "732-840-4300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2634503",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2012; 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.