Organization Active NPI

Garden State Cardiovascular Specialists P.C

  • Cardiovascular Disease Physician
  • Elizabeth, NJ
National Provider Identifier
1225059660
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
GARDEN STATE CARDIOVASCULAR SPECIALISTS P.C
Practice address
1150 Dickinson St
Elizabeth, NJ 07201-2210
Phone
(908) 354-8900
Fax
(908) 354-0007
NPI assigned
Jul 21, 2006
Last updated
Jun 19, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Authorized official

Name
Jasjit WaliaNPI 1477573814
Title
MD
Phone
(908) 587-9300

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
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

1150 Dickinson St
Elizabeth, NJ 07201-2210

Mailing address

520 N Wood Ave
Linden, NJ 07036-4147
Phone (908) 587-9300

Other practice location 1

635 Market St
Newark, NJ 07105-3618
Phone (973) 344-5454

Other practice location 2

520 N Wood Ave
Linden, NJ 07036-4147
Phone (908) 587-9300

Other practice location 3

550 Mount Prospect Ave
Newark, NJ 07104-1530
Phone (973) 482-4697

Other identifiers 1

IdentifierTypeStateIssuer
8966605MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040419000924 NJ Part B Supplier - Clinic/Group Practice 8527053511 Receives reassigned benefits from 34 practitioners
Practice locations: Elizabeth, NJ; Linden, NJ; Newark, NJ

National Provider Directory

National Provider Directory

Locations

1 Ethel Rd
Ste 102C
Edison, NJ 08817
Phone (732) 287-6663

240 Williamson St
Ste 402
Elizabeth, NJ 07202
Phone (908) 354-8900

Practitioners & affiliated clinicians

Practitioners 35

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 35

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1225059660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N WOOD AVE",
            "city": "LINDEN",
            "state": "NJ",
            "postal_code": "070364147",
            "telephone_number": "908-587-9300",
            "fax_number": "908-587-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 DICKINSON ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072012210",
            "telephone_number": "908-354-8900",
            "fax_number": "908-354-0007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "635 Market St",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071053618",
            "country_code": "US",
            "telephone_number": "973-344-5454",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "520 N Wood Ave",
            "address_purpose": "LOCATION",
            "city": "Linden",
            "state": "NJ",
            "postal_code": "070364147",
            "country_code": "US",
            "telephone_number": "908-587-9300",
            "fax_number": "908-587-1901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 Mount Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071041530",
            "country_code": "US",
            "telephone_number": "973-482-4697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GARDEN STATE CARDIOVASCULAR SPECIALISTS P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "WALIA",
        "authorized_official_first_name": "JASJIT",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "908-587-9300"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8966605",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.