NPIMap

Organization Active NPI

St. Luke's Warren Physician Group, PC

  • Vascular & Interventional Radiology Physician
  • Phillipsburg, NJ
National Provider Identifier
1326319195
Registry record updated Feb 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
ST. LUKE'S WARREN PHYSICIAN GROUP, PC
Practice address
755 Memorial Pkwy
Suite 106
Phillipsburg, NJ 08865-2748
Phone
(610) 252-8281
Fax
(610) 253-5321
NPI assigned
Jan 25, 2012
Last updated
Feb 1, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2018

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

Authorized official

Name
Gerard J Delmonico, MDNPI 1184683690
Title
President
Phone
(908) 859-6568

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X NU Primary

Addresses

Primary practice location

755 Memorial Pkwy
Suite 106
Phillipsburg, NJ 08865-2748

Mailing address

755 Memorial Pkwy Ste 102
Phillipsburg, NJ 08865-2774
Phone (484) 503-8281

Other identifiers 1

IdentifierTypeStateIssuer
7123604MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000020 NJ Part B Supplier - Clinic/Group Practice 9739093675 Receives reassigned benefits from 664 practitioners
40 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Belvidere, NJ; Washington, NJ; Phillipsburg, NJ; Hampton, NJ; Clinton, NJ

Other NPIs on the same Medicare enrollment 40

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 40

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517443200000",
    "number": "1326319195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 MEMORIAL PKWY STE 102",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652774",
            "telephone_number": "484-503-8281",
            "fax_number": "833-816-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 MEMORIAL PKWY",
            "address_2": "SUITE 106",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652748",
            "telephone_number": "610-252-8281",
            "fax_number": "610-253-5321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S WARREN PHYSICIAN GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-25",
        "last_updated": "2018-02-01",
        "status": "A",
        "authorized_official_last_name": "DELMONICO",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-859-6568",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7123604",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; 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.