Prime Endocrinology, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PRIME ENDOCRINOLOGY, LLC

Practice address

103 Parker Rd Ste B
West Long Branch, NJ 07764-1009

Phone

(732) 222-0307

NPI assigned

Oct 19, 2018

Last updated

Oct 19, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sudha Ganne, MDNPI 1376747618

Title

Physician Owner

Phone

(732) 222-0307

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Sudha Ganne, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • West Long Branch, NJ
  • NPI 1376747618
  Medicare reassignment Care Compare group NPD Authorized official
• Lisa Ertle, APRN

  • Family Nurse Practitioner
  • West Long Branch, NJ
  • NPI 1891583274
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539907200000",
    "number": "1306312095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 PARKER RD STE B",
            "city": "WEST LONG BRANCH",
            "state": "NJ",
            "postal_code": "077641009",
            "telephone_number": "732-222-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 PARKER RD STE B",
            "city": "WEST LONG BRANCH",
            "state": "NJ",
            "postal_code": "077641009",
            "telephone_number": "732-222-0307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME ENDOCRINOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-19",
        "last_updated": "2018-10-19",
        "status": "A",
        "authorized_official_last_name": "GANNE",
        "authorized_official_first_name": "SUDHA",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "732-222-0307",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Nicole Piccillo
• Michael Pignataro, DMD
• Anabela Pires
• Jennifer D. Pompliano, D.O.
• Victoria Porter
• Rosbel Maria Puello, MA, LPC, NCC
• Patricia Quinn
• R.C .Lillie S.J. Marder, D.P.M.'S
• Colleen M Rackett, ATC
• Melanie Ramp, APN-C

• Primary Care Clinic/Center in West Long Branch, NJ
• Providers in West Long Branch, NJ by specialty
• Primary Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; 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.