NPIMap

Organization Active NPI

Lakewood Urology Limited Liability Company

  • Urology Physician
  • Hamilton, NJ
National Provider Identifier
1356569388
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
LAKEWOOD UROLOGY LIMITED LIABILITY COMPANY
Practice address
1374 Whitehorse Hamilton Square Rd
Suite 101
Hamilton, NJ 08690-3701
Phone
(609) 581-5900
Fax
(609) 581-5901
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Authorized official

Name
Mukaram Gazi, M.D.NPI 1679527188
Title
Owner
Phone
(609) 581-5900

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
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

1374 Whitehorse Hamilton Square Rd
Suite 101
Hamilton, NJ 08690-3701

Mailing address

1374 Whitehorse Hamilton Square Rd
Suite 101
Hamilton, NJ 08690-3701
Phone (609) 581-5900

Other identifiers 6

IdentifierTypeStateIssuer
0019429MedicaidNJ
P2564828OtherNJOXFORD
91001110700OtherNJAMERICHOICE
2636882000OtherNJAMERIHEALTH
2958547OtherNJAETNA
2K5726OtherNJHEALTHNET

Other names 1

  • University Urology Associates of New Jersey Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080220000319 NJ Part B Supplier - Clinic/Group Practice 9032293709 Receives reassigned benefits from 9 practitioners
Practice locations: Freehold, NJ; Hamilton, NJ; Lakewood, NJ; Toms River, NJ; Whiting, NJ

National Provider Directory

National Provider Directory

Locations

2364 US Highway 9
Unit B2
Howell, NJ 07731

490 County Road 530
Whiting, NJ 08759

490 County Road 530
Ofc
Whiting, NJ 08759
Phone (609) 581-5900

Practitioners & affiliated clinicians

Practitioners 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403481600000",
    "number": "1356569388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1374 WHITEHORSE HAMILTON SQUARE RD",
            "address_2": "SUITE 101",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086903701",
            "telephone_number": "609-581-5900",
            "fax_number": "609-581-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1374 WHITEHORSE HAMILTON SQUARE RD",
            "address_2": "SUITE 101",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086903701",
            "telephone_number": "609-581-5900",
            "fax_number": "609-581-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD UROLOGY LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2014-06-23",
        "status": "A",
        "authorized_official_last_name": "GAZI",
        "authorized_official_first_name": "MUKARAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-581-5900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019429",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2564828",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "91001110700",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2636882000",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2958547",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "2K5726",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Urology Associates of New Jersey",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hamilton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; 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.