NPIMap

Organization Active NPI

Medassist NJ II

  • Geriatric Medicine (Family Medicine) Physician
  • Lakewood, NJ
National Provider Identifier
1336928407
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
MEDASSIST NJ II
Practice address
419 E County Line Rd
Lakewood, NJ 08701-1426
Phone
(917) 882-4536
NPI assigned
Sep 27, 2023
Last updated
Sep 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Authorized official

Name
Yehdua Schneider
Title
Manager
Phone
(917) 882-4536

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X NU Primary

Addresses

Primary practice location

419 E County Line Rd
Lakewood, NJ 08701-1426

Mailing address

419 E County Line Rd
Lakewood, NJ 08701-1426

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, MD, NY, PA4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20231029000065 NJ Part B Supplier - Clinic/Group Practice 1557717428 Receives reassigned benefits from 21 practitioners
Practice locations: Lakewood, NJ
O20231127003473 MD Part B Supplier - Clinic/Group Practice 1557717428 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD
O20231130003465 NY Part B Supplier - Clinic/Group Practice 1557717428 Receives reassigned benefits from 31 practitioners
Practice locations: Spring Valley, NY
O20240122002706 PA Part B Supplier - Clinic/Group Practice 1557717428 Receives reassigned benefits from 4 practitioners
Practice locations: Erie, PA

National Provider Directory

National Provider Directory

Locations

747 Chestnut Ridge Rd
#205
Spring Valley, NY 10977

747 Chestnut Ridge Rd
Ste 205
Spring Valley, NY 10977
Phone (845) 237-2381

Practitioners & affiliated clinicians

Practitioners 47

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 47

NPI Registry JSON

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1336928407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 E COUNTY LINE RD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087011426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 E COUNTY LINE RD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087011426",
            "telephone_number": "917-882-4536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDASSIST NJ II",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-27",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "SCHNEIDER",
        "authorized_official_first_name": "YEHDUA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "917-882-4536"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.