NPIMap

Organization Active NPI

Raritan Bay Medical Center Professional Services

  • Specialist
  • Fords, NJ
National Provider Identifier
1245330588
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MA05842900 Issued in NJ
Legal business name
RARITAN BAY MEDICAL CENTER PROFESSIONAL SERVICES
Practice address
390 New Brunswick Ave
Fords, NJ 08863-2110
Phone
(732) 738-4260
Fax
(732) 738-5693
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Tom Shanahan
Title
Ceo
Phone
(732) 293-2314

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 25MA02674500 NJ
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 25MA04981500 NJ
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 25MA05842900 NJ Primary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 25MA07930600 NJ

Addresses

Primary practice location

390 New Brunswick Ave
Fords, NJ 08863-2110

Mailing address

PO Box 48270
Newark, NJ 07101-4800
Phone (201) 818-9118

National Provider Directory

National Provider Directory
Tax ID family
Raritan Bay Medical Center Professional Services7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245330588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48270",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071014800",
            "telephone_number": "201-818-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 NEW BRUNSWICK AVE",
            "city": "FORDS",
            "state": "NJ",
            "postal_code": "088632110",
            "telephone_number": "732-738-4260",
            "fax_number": "732-738-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RARITAN BAY MEDICAL CENTER PROFESSIONAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHANAHAN",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "732-293-2314"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA02674500",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA04981500",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA05842900",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA07930600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fords, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.