NPIMap

Organization Active NPI

Middletown Pediatrics, P.a.

  • Pediatric Adolescent Medicine Physician
  • Red Bank, NJ
National Provider Identifier
1275757916
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
MIDDLETOWN PEDIATRICS, P.A.
Practice address
529 Hwy #35
Red Bank, NJ 07701-5037
Phone
(732) 741-9800
Fax
(732) 758-6367
NPI assigned
Apr 12, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Mrs. Kathleen E Ready
Title
Office Manager
Phone
(732) 741-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X Primary

Addresses

Primary practice location

529 Hwy #35
Red Bank, NJ 07701-5037

Mailing address

529 Hwy #35
Red Bank, NJ 07701-5037
Phone (732) 741-9800

Other identifiers 3

IdentifierTypeStateIssuer
0600008MedicaidNJ
0882909MedicaidNJ
2905302MedicaidNJ

National Provider Directory

National Provider Directory

Locations

529 State Route 35
Red Bank, NJ 07701
Phone (732) 741-9800

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275757916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 HWY #35",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015037",
            "telephone_number": "732-741-9800",
            "fax_number": "732-758-6367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 HWY #35",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077015037",
            "telephone_number": "732-741-9800",
            "fax_number": "732-758-6367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLETOWN PEDIATRICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "READY",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "732-741-9800",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0600008",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0882909",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2905302",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, 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.