Organization Active NPI

Bayshore Medical Associates, Inc

  • Physical Medicine & Rehabilitation Physician
  • Toms River, NJ
National Provider Identifier
1447483946
Registry record updated Aug 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MBO63894 Issued in NJ
Legal business name
BAYSHORE MEDICAL ASSOCIATES, INC
Practice address
508 Lakehurst Rd Ste 3B
Toms River, NJ 08755-8000
Phone
(609) 242-2705
Fax
(609) 312-7195
NPI assigned
Aug 31, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2009

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

Authorized official

Name
Dr. Robert Brian Kelly, D.O.
Title
President / Medical Doctor
Phone
(732) 804-8590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X MBO63894 NJ Primary

Addresses

Primary practice location

508 Lakehurst Rd Ste 3B
Toms River, NJ 08755-8000

Mailing address

PO Box 659
Lanoka Harbor, NJ 08734-0659
Phone (609) 242-2705

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1251676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251676800000",
    "number": "1447483946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 659",
            "city": "LANOKA HARBOR",
            "state": "NJ",
            "postal_code": "087340659",
            "telephone_number": "609-242-2705",
            "fax_number": "609-312-7195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 LAKEHURST RD STE 3B",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087558000",
            "telephone_number": "609-242-2705",
            "fax_number": "609-312-7195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSHORE MEDICAL ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-31",
        "last_updated": "2009-08-31",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT / MEDICAL DOCTOR",
        "authorized_official_telephone_number": "732-804-8590",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "MBO63894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.