NPIMap

Organization Active NPI

Summit Medical Group PA

  • Durable Medical Equipment & Medical Supplies
  • West Orange, NJ
National Provider Identifier
1245950799
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SUMMIT MEDICAL GROUP PA
Practice address
1500 Pleasant Valley Way
West Orange, NJ 07052-2956
Phone
(973) 577-5954
NPI assigned
Sep 2, 2022
Last updated
Sep 2, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
SUMMIT MEDICAL GROUP PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Authorized official

Name
Peter T Saunders
Title
Senior VP
Phone
(908) 588-3930

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1500 Pleasant Valley Way
West Orange, NJ 07052-2956

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 588-3635

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240201001290 NJ DME Supplier - Physician - Orthopedic/Orthopedic SurgeryDME Supplier - Physician - PodiatryDME Supplier - Other 5395642276 Practice locations: West Orange, NJ

Other NPIs with the same Medicare PAC ID 23

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 23

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D1101685Summit Medical Group, PA1500 Pleasant Valley Way, West Orange, NJ 07052Certificate of waiverSep 22, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Summit Medical Group PA1500 Pleasant Valley Way, West Orange, NJ 07052(973) 669-5600 Contracture Treatment Devices: Dynamic Splint|Heat & Cold Applications|Neuromuscular Elect Stimulators (NMES)/Supplies|(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies|Canes and/or Crutches|Walkers|Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthose… Accepts assignmentParticipating since Jan 1, 1993

National Provider Directory

National Provider Directory
Tax ID family
Summit Medical84 organizations share this tax ID, including this one
Part of
Summit Medical

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662076800000",
    "number": "1245950799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-588-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PLEASANT VALLEY WAY",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522956",
            "telephone_number": "973-577-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT MEDICAL GROUP PA",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A",
        "authorized_official_last_name": "SAUNDERS",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "SENIOR VP",
        "authorized_official_telephone_number": "908-588-3930"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.