Active NPI
Peter J Stewart, MD
- Surgery Physician
- Hackensack, NJ
National Provider Identifier
1255302592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 060260
- Practice address
- 30 Prospect Ave
Hackensack, NJ 07601-1914 - Phone
- (201) 996-2609
- NPI assigned
- Jan 26, 2006
- Last updated
- Jun 17, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 060260 | NJ | Primary |
| Trauma Surgery Physician | 2086S0127X | 060260 | NJ | |
| Surgical Critical Care Physician | 2086S0102X | 060260 | NJ |
Addresses
Primary practice location
30 Prospect Ave
Hackensack, NJ 07601-1914
Mailing address
30 Prospect Ave
Hackensack, NJ 07601-1914
Phone (201) 996-2609
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6034209 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 060260 | NJ | MD | Surgical Critical Care Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Jersey Trauma and Critical Care Associates, PC | Trauma Surgery | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Trauma Surgery Physician
- Hackensack, NJ
- NPI 1558313650
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213660800000",
"number": "1255302592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 PROSPECT AVE",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076011914",
"telephone_number": "201-996-2609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 PROSPECT AVE",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076011914",
"telephone_number": "201-996-2609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "PETER",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-26",
"last_updated": "2008-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "NJ",
"license": "060260",
"primary": true
},
{
"code": "2086S0127X",
"taxonomy_group": "",
"desc": "Surgery, Trauma Surgery",
"state": "NJ",
"license": "060260",
"primary": false
},
{
"code": "2086S0102X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Critical Care",
"state": "NJ",
"license": "060260",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6034209",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.