NPIMap

Organization Active NPI

Jersey Med Well

  • Anesthesiology Physician
  • Manasquan, NJ
National Provider Identifier
1356133409
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
JERSEY MED WELL
Practice address
1913 Atlantic Ave Ste 251-a
Manasquan, NJ 08736-1029
Phone
(718) 957-1342
NPI assigned
May 22, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Authorized official

Name
Ira A Klein
Title
Owner
Phone
(201) 842-3978

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

1913 Atlantic Ave Ste 251-a
Manasquan, NJ 08736-1029

Mailing address

1913 Atlantic Ave Ste 251-a
Manasquan, NJ 08736-1029

Other names 1

  • TRI STATE WOUND Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250604000153 NJ Part B Supplier - Clinic/Group Practice 1557870235 Receives reassigned benefits from 9 practitioners
Practice locations: Manasquan, NJ
O20260130002404 NJ DME Supplier - Physician - Anesthesiology 1557870235 Practice locations: Manasquan, NJ

National Provider Directory

National Provider Directory

Locations

1913 Atlantic Ave
Ste 251A
Manasquan, NJ 08736
Phone (718) 957-1342

Practitioners & affiliated clinicians

Practitioners 10

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": "1747872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1356133409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1913 ATLANTIC AVE STE 251-A",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087361029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 ATLANTIC AVE STE 251-A",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087361029",
            "telephone_number": "718-957-1342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY MED WELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "IRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-842-3978"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRI STATE WOUND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manasquan, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; 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.