NPIMap

Organization Active NPI

Urology Group PA

  • Urology Physician
  • Midland Park, NJ
National Provider Identifier
1427012897
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
UROLOGY GROUP PA
Practice address
4 Godwin Avenue
Midland Park, NJ 07432
Phone
(201) 444-7070
Fax
(201) 444-7712
NPI assigned
Apr 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Authorized official

Name
Dr. Howard Lawrence Frey, MD
Title
President
Phone
(201) 444-7070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

4 Godwin Avenue
Midland Park, NJ 07432

Mailing address

4 Godwin Avenue
Midland Park, NJ 07432
Phone (201) 444-7070

Other identifiers 4

IdentifierTypeStateIssuer
195070301MedicaidNJ
8247901MedicaidNJ
1126601MedicaidNJ
8248001MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040804000458 NJ Part B Supplier - Clinic/Group Practice 7214908102 Receives reassigned benefits from 9 practitioners
Practice locations: Midland Park, NJ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0110154Urology Group, PA4 Godwin Avenue, Midland Park, NJ 07432ComplianceSep 19, 2027

National Provider Directory

National Provider Directory

Locations

4 Godwin Ave
Midland Park, NJ 07432
Phone (201) 444-7070

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277856000000",
    "number": "1427012897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GODWIN AVENUE",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "07432",
            "telephone_number": "201-444-7070",
            "fax_number": "201-444-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GODWIN AVENUE",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "07432",
            "telephone_number": "201-444-7070",
            "fax_number": "201-444-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2010-06-30",
        "status": "A",
        "authorized_official_last_name": "FREY",
        "authorized_official_first_name": "HOWARD",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-444-7070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195070301",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8247901",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1126601",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8248001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.