Individual provider Active NPI

Jennifer Rose Syrek, M.D.

  • Family Medicine Physician
  • Old Bridge, NJ
National Provider Identifier
1225097066
Registry record updated Dec 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA07201800 Issued in NJ
Practice address
499 Marlboro Rd
Suite 1
Old Bridge, NJ 08857-3746
Phone
(732) 307-2300
Fax
(732) 307-2303
NPI assigned
Mar 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 25MA07201800 NJ
Family Medicine Physician 207Q00000X 25MA07201800 NJ Primary

Addresses

Primary practice location

499 Marlboro Rd
Suite 1
Old Bridge, NJ 08857-3746

Mailing address

3601 SW 160TH Ave Ste 250
Miramar, FL 33027-6314
Phone (877) 866-7123

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Central Jersey Surgical Specialists, P.a. Specialist PastSince Jan 5, 2020 Accepting new patients
Podiatry & Ankle Center of Excellence, LLC Past Accepting new patients

Organizations & group practices 2

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512432000000",
    "number": "1225097066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE STE 250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276314",
            "telephone_number": "877-866-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 MARLBORO RD",
            "address_2": "SUITE 1",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088573746",
            "telephone_number": "732-307-2300",
            "fax_number": "732-307-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYREK",
        "first_name": "JENNIFER",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2017-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA07201800",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA07201800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; 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.