Shore Surgical Assisting LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00132300 Issued in NJ

Legal business name

SHORE SURGICAL ASSISTING LLC

Practice address

1070 Clearwater Ave
Manahawkin, NJ 08050-2303

Phone

(732) 236-1104

Fax

(609) 978-2750

NPI assigned

Apr 24, 2012

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Donn M Hoosack, PA-CNPI 1194777375

Title

Owner

Phone

(732) 236-1104

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

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.

• Donn Matthew Hoosack, PA-C

  • Physician Assistant
  • Point Pleasant Beach, NJ
  • NPI 1194777375
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1235497561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 CLEARWATER AVE",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502303",
            "telephone_number": "732-236-1104",
            "fax_number": "609-978-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 CLEARWATER AVE",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080502303",
            "telephone_number": "732-236-1104",
            "fax_number": "609-978-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE SURGICAL ASSISTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-24",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "HOOSACK",
        "authorized_official_first_name": "DONN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-236-1104",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00132300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT LICENSE",
            "identifier": "25MP00132300",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS",
            "identifier": "A00006300",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hemangini R Shah, D.O.
• Alyssa Sheppard
• Kathryn Marie Sheridan
• Nagalakshmi A. Shetty, M.D
• Shore Hearing Aid Center Inc
• Shorefit Training LLC
• Seth Andrew Shugar
• Louis Siciliano, MD
• Charles Sidwa, PA
• Pamela Jean Simone, OTR

• Surgical Physician Assistant in Manahawkin, NJ
• Providers in Manahawkin, NJ by specialty
• Surgical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.