Individual provider Active NPI

Edward M Maron, MD

  • Internal Medicine Physician
  • Lakewood, NJ
National Provider Identifier
1275526568
Registry record updated Jun 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
40456 Issued in NJ
Practice address
500 River Ave Ste 140
Lakewood, NJ 08701-4743
Phone
(732) 363-7200
Fax
(732) 363-8183
NPI assigned
Aug 23, 2005
Last updated
Jun 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 40456 NJ Primary

Addresses

Primary practice location

500 River Ave Ste 140
Lakewood, NJ 08701-4743

Mailing address

500 River Ave Ste 140
Lakewood, NJ 08701-4743
Phone (732) 363-7200

Other identifiers 1

IdentifierTypeStateIssuer
1288903MedicaidNJ

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

LicenseStateTypeSpecialty
40456NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shore Medical Specialists Internal Medicine CurrentSince Aug 13, 2023 Accepting new patients
Shoremedical5 LLC Internal Medicine PastSince Sep 5, 2023 Accepting new patients

Locations

500 River Ave
Ste 140
Lakewood, NJ 08701
Phone (732) 363-0720

9 Hospital Dr
Ste B1
Toms River, NJ 08755
Phone (732) 349-2732

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309305600000",
    "number": "1275526568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 RIVER AVE STE 140",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014743",
            "telephone_number": "732-363-7200",
            "fax_number": "732-363-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 RIVER AVE STE 140",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087014743",
            "telephone_number": "732-363-7200",
            "fax_number": "732-363-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARON",
        "first_name": "EDWARD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2011-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "40456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1288903",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; 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.