Active NPI
Paul C Hiley, MD
- Gastroenterology Physician
- Jackson, NJ
National Provider Identifier
1336145176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- MA21728
- Practice address
- 2290 W County Line Rd
Jackson, NJ 08527-2267 - Phone
- (732) 364-3881
- Fax
- (732) 364-4625
- NPI assigned
- Jun 27, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | MA21728 | NJ | Primary |
| Internal Medicine Physician | 207R00000X | MA21728 | NJ |
Addresses
Primary practice location
2290 W County Line Rd
Jackson, NJ 08527-2267
Mailing address
2290 W. County Line Road
Jackson, NJ 08527
Phone (732) 942-4455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3841600 | 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 |
|---|---|---|---|
| MA21728 | NJ | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424390400000",
"number": "1336145176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2290 W. COUNTY LINE ROAD",
"city": "JACKSON",
"state": "NJ",
"postal_code": "08527",
"telephone_number": "732-942-4455",
"fax_number": "732-942-4459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2290 W COUNTY LINE RD",
"city": "JACKSON",
"state": "NJ",
"postal_code": "085272267",
"telephone_number": "732-364-3881",
"fax_number": "732-364-4625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILEY",
"first_name": "PAUL",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-27",
"last_updated": "2015-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NJ",
"license": "MA21728",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NJ",
"license": "MA21728",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3841600",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.