Patient Care Medical Group Nevada LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PATIENT CARE MEDICAL GROUP NEVADA LLC

Practice address

26 Main St
Edison, NJ 08837-3418

Phone

(609) 521-4746

NPI assigned

Sep 18, 2023

Organization subpart

No

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

Authorized official

Name

Andrew Pecora

Title

Owner

Phone

(609) 744-0050

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1225816770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 MAIN ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088373418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 MAIN ST",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088373418",
            "telephone_number": "609-521-4746"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 W Horizon Ridge Pkwy Ste 204",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890124840",
            "country_code": "US",
            "telephone_number": "702-779-0147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PATIENT CARE MEDICAL GROUP NEVADA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-17",
        "status": "A",
        "authorized_official_last_name": "PECORA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-744-0050"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vishwa Patel
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• Manoj Dinkar Patharkar, M.D.
• Patient Care Medical Group Delaware LLC
• Patient Care Medical Group New York LLC
• Patient Care Medical Group Ohio LLC
• Patient Care Medical Group Pennsylvania LLC
• Patient Care Medical Group Texas LLC
• Patient Care Medical Group Virginia LLC

• Family Medicine Physician in Edison, NJ
• Providers in Edison, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.