NPIMap

Organization Active NPI

Rutgers Health-RWJ Scleroderma Program

  • Neurology Physician
  • New Brunswick, NJ
National Provider Identifier
1366487183
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
RUTGERS HEALTH-RWJ SCLERODERMA PROGRAM
Practice address
125 Paterson St
Suite 6100
New Brunswick, NJ 08901-1962
Phone
(732) 235-7733
Fax
(732) 235-7041
NPI assigned
Jun 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Authorized official

Name
Brenda Lawrence
Title
Director of Revenue Cycle
Phone
(732) 235-6070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

125 Paterson St
Suite 6100
New Brunswick, NJ 08901-1962

Mailing address

66 W Gilbert St
Tinton Falls, NJ 07701-4947
Phone (732) 212-0051

Other identifiers 1

IdentifierTypeStateIssuer
3470105MedicaidNJ

Other names 1

  • Rutgers Health-RWJ Neurology Group Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050502000326 NJ Part B Supplier - Clinic/Group Practice 5193764991 Receives reassigned benefits from 667 practitioners
38 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Brunswick, NJ; North Brunswick, NJ; Perth Amboy, NJ; Piscataway, NJ; Somerset, NJ; Somerville, NJ; Toms River, NJ; East Brunswick, NJ…

Other NPIs on the same Medicare enrollment 38

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 38

National Provider Directory

National Provider Directory

Locations

645 State Route 18
East Brunswick, NJ 08816
Phone (732) 390-1160

1 Rwj Pl
#4
New Brunswick, NJ 08901

125 Paterson St
Ste 6200
New Brunswick, NJ 08901
Phone (732) 235-3288

10 Plum St
Fl 8
New Brunswick, NJ 08901
Phone (732) 235-5530

210 Somerset St
Fl 9
New Brunswick, NJ 08901

210 Somerset St
Fl 10
New Brunswick, NJ 08901

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1366487183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 W GILBERT ST",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014947",
            "telephone_number": "732-212-0051",
            "fax_number": "732-212-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST",
            "address_2": "SUITE 6100",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962",
            "telephone_number": "732-235-7733",
            "fax_number": "732-235-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTGERS HEALTH-RWJ SCLERODERMA PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "732-235-6070"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3470105",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rutgers Health-RWJ Neurology Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.