Organization Active NPI

Associates in Otolaryngology of NJ, LLC

  • Specialist
  • West Orange, NJ
National Provider Identifier
1417065392
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ASSOCIATES IN OTOLARYNGOLOGY OF NJ, LLC
Practice address
741 Northfield Ave
Suite 104
West Orange, NJ 07052-1174
Phone
(973) 243-0600
Fax
(973) 736-5702
NPI assigned
Aug 29, 2006
Last updated
Aug 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Authorized official

Name
Dr. Norman Holzberg, M.D.NPI 1689679904
Title
President
Phone
(973) 243-0600

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
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

741 Northfield Ave
Suite 104
West Orange, NJ 07052-1174

Mailing address

741 Northfield Ave
Suite 104
West Orange, NJ 07052-1174
Phone (973) 243-0600

Other identifiers 1

IdentifierTypeStateIssuer
2606909MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040202000090 NJ Part B Supplier - Clinic/Group Practice 7113820572 Receives reassigned benefits from 22 practitioners
Practice locations: Summit, NJ; West Orange, NJ

National Provider Directory

National Provider Directory

Locations

47 Maple St
Ste 206
Summit, NJ 07901
Phone (908) 522-0047

741 Northfield Ave
Ste 104A
West Orange, NJ 07052
Phone (973) 731-6115

741 Northfield Ave
Ste 104
West Orange, NJ 07052
Phone (201) 243-0600

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1417065392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 NORTHFIELD AVE",
            "address_2": "SUITE 104",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521174",
            "telephone_number": "973-243-0600",
            "fax_number": "973-736-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 NORTHFIELD AVE",
            "address_2": "SUITE 104",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521174",
            "telephone_number": "973-243-0600",
            "fax_number": "973-736-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES IN OTOLARYNGOLOGY OF NJ, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "HOLZBERG",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-243-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2606909",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.