Organization Active NPI

Jersey Shore Cardiothoracic and Vascular Surgery Associates PA

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Ocean, NJ
National Provider Identifier
1225187883
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MA40670 Issued in NJ
Legal business name
JERSEY SHORE CARDIOTHORACIC AND VASCULAR SURGERY ASSOCIATES PA
Practice address
301 Bingham Ave
Suite a
Ocean, NJ 07712-4762
Phone
(732) 775-9077
Fax
(732) 988-7852
NPI assigned
Jan 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Authorized official

Name
Robert M Thompson, M.D.NPI 1760480909
Title
President
Phone
(732) 775-9077

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
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X MA40670 NJ Primary

Addresses

Primary practice location

301 Bingham Ave
Suite a
Ocean, NJ 07712-4762

Mailing address

301 Bingham Ave
Suite a
Ocean, NJ 07712-4762
Phone (732) 775-9077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090409000112 NJ Part B Supplier - Clinic/Group Practice 6204983232 Receives reassigned benefits from 1 practitioner
Practice locations: Wall, NJ

National Provider Directory

National Provider Directory

Locations

234 Industrial Way W
Ste A103
Eatontown, NJ 07724
Phone (848) 208-2055

301 Bingham Ave
Ste A
Ocean, NJ 07712
Phone (732) 775-9077

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1225187883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BINGHAM AVE",
            "address_2": "SUITE A",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "077124762",
            "telephone_number": "732-775-9077",
            "fax_number": "732-988-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 BINGHAM AVE",
            "address_2": "SUITE A",
            "city": "OCEAN",
            "state": "NJ",
            "postal_code": "077124762",
            "telephone_number": "732-775-9077",
            "fax_number": "732-988-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY SHORE CARDIOTHORACIC AND VASCULAR SURGERY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-775-9077",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NJ",
            "license": "MA40670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; 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.