NPIMap

Organization Active NPI

Sea Girt Physical Medicine and Rehabilitation Associates, LLC

  • Physical Medicine & Rehabilitation Physician
  • Manasquan, NJ
National Provider Identifier
1407004195
Registry record updated Dec 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
SEA GIRT PHYSICAL MEDICINE AND REHABILITATION ASSOCIATES, LLC
Practice address
240 Parker Ave
Manasquan, NJ 08736-2804
Phone
(732) 974-8100
Fax
(732) 974-9125
NPI assigned
Sep 5, 2008
Last updated
Dec 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2021

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

Authorized official

Name
Dr. Michael Dambeck, DONPI 1851562987
Title
Member
Phone
(732) 974-8100

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
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

240 Parker Ave
Manasquan, NJ 08736-2804

Mailing address

240 Parker Ave
Manasquan, NJ 08736-2804
Phone (732) 974-8100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090209000120 NJ Part B Supplier - Clinic/Group Practice 6608931647 Receives reassigned benefits from 23 practitioners
Practice locations: Wall Township, NJ; Freehold, NJ; Point Pleasant Boro, NJ; Ocean Grove, NJ; Neptune City, NJ; Manasquan, NJ; Neptune, NJ; Allenwood, NJ…

National Provider Directory

National Provider Directory

Locations

115 Dutch Lane Rd
Freehold, NJ 07728
Phone (732) 431-7420

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638662400000",
    "number": "1407004195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 PARKER AVE",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087362804",
            "telephone_number": "732-974-8100",
            "fax_number": "732-974-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 PARKER AVE",
            "city": "MANASQUAN",
            "state": "NJ",
            "postal_code": "087362804",
            "telephone_number": "732-974-8100",
            "fax_number": "732-974-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA GIRT PHYSICAL MEDICINE AND REHABILITATION ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-05",
        "last_updated": "2021-12-05",
        "certification_date": "2021-12-05",
        "status": "A",
        "authorized_official_last_name": "DAMBECK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "732-974-8100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 5, 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.