NPIMap

Individual provider Active NPI

Samuel Caruthers, M.D.

  • Anesthesiology Physician
  • Boonton, NJ
National Provider Identifier
1225034887
Registry record updated Dec 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA07863200 Issued in NJ
Practice address
408 Main St Ste 101D
Boonton, NJ 07005-1799
Phone
(862) 222-4629
Fax
(973) 352-9519
NPI assigned
Jun 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 217213 NY
Pain Medicine (Anesthesiology) Physician 207LP2900X 25MA07863200 NJ
Pain Medicine (Anesthesiology) Physician 207LP2900X 217213 NY
Anesthesiology Physician 207L00000X 25MA07863200 NJ Primary

Addresses

Primary practice location

408 Main St Ste 101D
Boonton, NJ 07005-1799

Mailing address

P.O. Box 429
Mountain Lakes, NJ 07046-1119
Phone (862) 222-4629

Other identifiers 1

IdentifierTypeStateIssuer
402459100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Jersey Interventional Pain Center Current Accepting new patients
North Jersey Electrodiagnostics Current Accepting new patients
Parkway Pain Services PA Anesthesiology Past Accepting new patients
Morris Anesthesia Group, PA Pain Medicine Past Accepting new patients
Howard County Anesthesia Associates PA Anesthesiology Past Accepting new patients
Resolute Perioperative Services LLC Anesthesiology Past Accepting new patients
Lifebridge Anesthesia Associates, LLC Anesthesiology Past Accepting new patients
North American Partners in Anesthesia Maryland LLC Anesthesiology PastSince Jul 10, 2022 Accepting new patients
Parkway Anesthesiologists, PA Anesthesiology Past Accepting new patients

Locations

408 Main St
Ste 101D
Boonton, NJ 07005
Phone (862) 222-4629

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449446400000",
    "number": "1225034887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 429",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "070461119",
            "telephone_number": "862-222-4629",
            "fax_number": "973-352-9519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 MAIN ST STE 101D",
            "city": "BOONTON",
            "state": "NJ",
            "postal_code": "070051799",
            "telephone_number": "862-222-4629",
            "fax_number": "973-352-9519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARUTHERS",
        "first_name": "SAMUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2015-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "217213",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NJ",
            "license": "25MA07863200",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "217213",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA07863200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402459100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boonton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.