Individual provider Active NPI

Saad S. Antoun, M.D.

  • Urology Physician
  • Holmdel, NJ
National Provider Identifier
1386655348
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
25MA03116400 Issued in NJ
Practice address
733 N Beers St
Suite L 6
Holmdel, NJ 07733-1528
Phone
(732) 739-2200
Fax
(732) 739-8988
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20101129000274 NJ Practitioner - Urology 1557557808 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA03116400NJMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Jersey Urology LLC Urology Current
since Dec 1, 2019
Accepting new patients
Summit Medical Group, Inc Past Accepting new patients

Locations

36 Newark Ave
Ste 200
Belleville, NJ 07109
Phone (973) 759-6180

1515 Broad St
Ste B130
Bloomfield, NJ 07003
Phone (973) 842-2730

733 N Beers St
Ste L6
Holmdel, NJ 07733
Phone (732) 739-2200

2 Princess Rd
Ste 2J
Lawrenceville, NJ 08648
Phone (609) 895-1991

1103 W Sherman Ave
Ste 2B
Vineland, NJ 08360
Phone (856) 213-4035

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 25MA03116400 NJ Primary

Addresses

NPPES NPI Registry

Primary practice location

733 N Beers St
Suite L 6
Holmdel, NJ 07733-1528

Mailing address

733 N Beers St
Suite L 6
Holmdel, NJ 07733-1528
Phone (732) 739-2200

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
3025004MedicaidNJ

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address santoun10735@njurology.direct-ci.com New Jersey Urology LLC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 30, 2021.

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1386655348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 N BEERS ST",
            "address_2": "SUITE L 6",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331528",
            "telephone_number": "732-739-2200",
            "fax_number": "732-739-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 N BEERS ST",
            "address_2": "SUITE L 6",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331528",
            "telephone_number": "732-739-2200",
            "fax_number": "732-739-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOUN",
        "first_name": "SAAD",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NJ",
            "license": "25MA03116400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3025004",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "santoun10735@njurology.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "New Jersey Urology LLC",
            "address_1": "1515 Broad St",
            "address_2": "Suite B130",
            "city": "Bloomfield",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070033002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

Verify at the official NPI Registry.