Individual provider Active NPI

Andrew Harrison, M.D.

  • Specialist
  • Lakewood, NJ
National Provider Identifier
1457303166
Registry record updated Aug 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA 06286400 Issued in NJ
Practice address
101 Prospect St
Suite 107
Lakewood, NJ 08701-5020
Phone
(732) 905-8153
Fax
(732) 866-4660
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA 06286400 NJ Primary

Addresses

Primary practice location

101 Prospect St
Suite 107
Lakewood, NJ 08701-5020

Mailing address

101 Prospect St
Suite 107
Lakewood, NJ 08701-5020
Phone (732) 905-8153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080710000474 NJ Practitioner - Orthopedic Surgery 6709958549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Perelman School of Med at the University of Pennsylvania, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 Prospect St
Suite 107
Lakewood, NJ 08701-5003
Phone (732) 905-8153

Hospital & facility affiliations

  • Visiting Nurse Association of Central Jersey Home Care and Hospice Home health agency, Toms River, NJ, CCN 317067
  • Monmouth Medical Center-Southern Campus Hospital, Lakewood, NJ, CCN 310084
  • Community Medical Center Hospital, Toms River, NJ, CCN 310041

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MA 06286400NJMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Jersey Sports Medicine & Orthopaedic Center CurrentSince Sep 29, 1995 Accepting new patients

Locations

101 Prospect St
Ste 107
Lakewood, NJ 08701
Phone (609) 689-1229

1199 Pleasant Valley Way
West Orange, NJ 07052
Phone (973) 414-4755

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9c59f03b-784a-48b1-8226-af2410d7e79f/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218067200000",
    "number": "1457303166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PROSPECT ST",
            "address_2": "SUITE 107",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015020",
            "telephone_number": "732-905-8153",
            "fax_number": "732-866-4660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROSPECT ST",
            "address_2": "SUITE 107",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015020",
            "telephone_number": "732-905-8153",
            "fax_number": "732-866-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2008-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA 06286400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.