NPIMap

Organization Active NPI

Promed Pathology, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Flemington, NJ
National Provider Identifier
1336545508
Registry record updated May 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PROMED PATHOLOGY, LLC
Practice address
2100 Wescott Drive
Hunterdon Medical Center Pathology
Flemington, NJ 08822-4613
Phone
(908) 788-6407
Fax
(908) 237-2334
NPI assigned
Nov 14, 2014
Last updated
May 23, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2017

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

Authorized official

Name
Dr. Jory G Magidson, MDNPI 1669449526
Title
Managing Partner
Phone
(973) 971-5612

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X Primary

Addresses

Primary practice location

2100 Wescott Drive
Hunterdon Medical Center Pathology
Flemington, NJ 08822-4613

Mailing address

P. O. Box 743
Hackettstown, NJ 07840-0743
Phone (908) 979-0200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150331002609 NJ Part B Supplier - Clinic/Group Practice 6709103757 Receives reassigned benefits from 8 practitioners
Practice locations: Flemington, NJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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": "1415923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495497600000",
    "number": "1336545508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 743",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078400743",
            "telephone_number": "908-979-0200",
            "fax_number": "908-979-9934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 WESCOTT DRIVE",
            "address_2": "HUNTERDON MEDICAL CENTER PATHOLOGY",
            "city": "FLEMINGTON",
            "state": "NJ",
            "postal_code": "088224613",
            "telephone_number": "908-788-6407",
            "fax_number": "908-237-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMED PATHOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-14",
        "last_updated": "2017-05-23",
        "status": "A",
        "authorized_official_last_name": "MAGIDSON",
        "authorized_official_first_name": "JORY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "973-971-5612",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flemington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2017; 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.