Southshore Medical Associates, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SOUTHSHORE MEDICAL ASSOCIATES, LLC

Practice address

1 Bethany Rd
Suite 35
Hazlet, NJ 07730-1663

Phone

(732) 888-1203

Fax

(732) 888-1204

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Lin Xu, M.D.NPI 1386671071

Title

Maneger

Phone

(732) 888-1203

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

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.

• Lin Xu, M.D.

  • Internal Medicine Physician
  • Hazlet, NJ
  • NPI 1386671071
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277683200000",
    "number": "1316157464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BETHANY RD",
            "address_2": "SUITE 35",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301663",
            "telephone_number": "732-888-1203",
            "fax_number": "732-888-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BETHANY RD",
            "address_2": "SUITE 35",
            "city": "HAZLET",
            "state": "NJ",
            "postal_code": "077301663",
            "telephone_number": "732-888-1203",
            "fax_number": "732-888-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSHORE MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2010-06-28",
        "status": "A",
        "authorized_official_last_name": "XU",
        "authorized_official_first_name": "LIN",
        "authorized_official_title_or_position": "MANEGER",
        "authorized_official_telephone_number": "732-888-1203",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "309505",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Smith, OTR/L
• Lynn E Snyder, PT
• Pedro A Solis, MD
• Alexandria Kate Sosa Mistry, LCSW
• Soul Work LLC (Soul Work Counseling Services)
• Charles R Spatz, DPM
• Speech Start LLC
• Elizabeth Spina, MA CCC SLP SLS
• Srinivas Pavuluri, MD, PA
• Stacy Horne LCSW LLC

• Specialist in Hazlet, NJ
• Providers in Hazlet, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.