NPIMap

Organization Active NPI

Trellus Medicine PC

  • Primary Care Clinic/Center
  • Ridgewood, NJ
National Provider Identifier
1346912110
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
TRELLUS MEDICINE PC
Practice address
45 N Broad St
Ridgewood, NJ 07450-3856
Phone
(800) 989-5503
NPI assigned
Sep 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Authorized official

Name
Andres Jimenez, MDNPI 1689843534
Title
Chief Medical Offer
Phone
(214) 679-1220

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
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

45 N Broad St
Ridgewood, NJ 07450-3856

Mailing address

250 Pehle Ave Ste 200
Saddle Brook, NJ 07663-5835

Other names 1

  • Connected Health Medicine Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1346912110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PEHLE AVE STE 200",
            "city": "SADDLE BROOK",
            "state": "NJ",
            "postal_code": "076635835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 N BROAD ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503856",
            "telephone_number": "800-989-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRELLUS MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-30",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "ANDRES",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFER",
        "authorized_official_telephone_number": "214-679-1220",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Connected Health Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Connected Health Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.