NPIMap

Organization Active NPI

Hackensack Meridian Outpatient Services, Inc.

  • Radiology Clinic/Center
  • Eatontown, NJ
National Provider Identifier
1407573314
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
HACKENSACK MERIDIAN OUTPATIENT SERVICES, INC.
Practice address
135 RT 35
Eatontown, NJ 07724
Phone
(848) 308-4902
Fax
(848) 308-4989
NPI assigned
Oct 21, 2022
Organization subpart
Yes
Parent organization
HACKENSACK MERIDIAN AMBULATORY CARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Authorized official

Name
James De Rosa
Title
Evp Financial Services
Phone
(551) 996-3362

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

135 RT 35
Eatontown, NJ 07724

Mailing address

135 RT 35
Eatontown, NJ 07724
Phone (848) 308-4902

Other names 1

  • Hackensack Meridian Imaging Eatontown Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230411002555 NJ Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7113392812 Practice locations: Eatontown, NJ

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Meridian Home Care SVC Inc25 organizations share this tax ID, including this one
Part of
Meridian Home Care SVC Inc

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1407573314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 RT 35",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "07724",
            "telephone_number": "848-308-4902",
            "fax_number": "848-308-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 RT 35",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "07724",
            "telephone_number": "848-308-4902",
            "fax_number": "848-308-4989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKENSACK MERIDIAN OUTPATIENT SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HACKENSACK MERIDIAN AMBULATORY CARE, INC.",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "DE ROSA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "EVP FINANCIAL SERVICES",
        "authorized_official_telephone_number": "551-996-3362"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hackensack Meridian Imaging Eatontown",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hackensack Meridian Imaging Eatontown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eatontown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.