Active NPI
Edward M Maron, MD
- Internal Medicine Physician
- Lakewood, NJ
National Provider Identifier
1275526568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 40456
- 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, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1288903 | 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 |
|---|---|---|---|
| 40456 | NJ | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shore Medical Specialists | Internal Medicine | Current | Accepting new patients |
| Shoremedical5 LLC | Internal Medicine | Past | 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.
-
- Internal Medicine Physician
- Toms River, NJ
- NPI 1134217417
-
- Internal Medicine Physician
- Toms River, NJ
- NPI 1962981944
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.