Prudentmd LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

25MA08134000 Issued in NJ

Legal business name

PRUDENTMD LLC

Practice address

5 Dundee Avenue
Iselin, NJ 08830-2118

Phone

(732) 404-0044

Fax

(800) 310-0849

NPI assigned

Apr 11, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Maitri Patel, MDNPI 1043398076

Title

Physician Owner

Phone

(732) 404-0044

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 5

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

• Maitri Patel, MD

  • Internal Medicine Physician
  • Iselin, NJ
  • NPI 1043398076
  Medicare reassignment Care Compare group Authorized official
• Anneta Vladimirovna Golubchik, M.D.

  • Internal Medicine Physician
  • Iselin, NJ
  • NPI 1861511610
  Medicare reassignment Care Compare group
• Jessica Benjamin, PA-C

  • Physician Assistant
  • Iselin, NJ
  • NPI 1992439251
  Medicare reassignment
• Shreya Mahajan, PA-C

  • Physician Assistant
  • Iselin, NJ
  • NPI 1972474179
  NPD (past)
• Ekta H Makani

  • Family Nurse Practitioner
  • Iselin, NJ
  • NPI 1689156291
  NPD (past)

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222387200000",
    "number": "1457524217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 DUNDEE AVENUE",
            "city": "ISELIN",
            "state": "NJ",
            "postal_code": "088302118",
            "telephone_number": "732-404-0044",
            "fax_number": "800-310-0849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 DUNDEE AVENUE",
            "city": "ISELIN",
            "state": "NJ",
            "postal_code": "088302118",
            "telephone_number": "732-404-0044",
            "fax_number": "800-310-0849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUDENTMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2008-09-26",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MAITRI",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "732-404-0044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NJ",
            "license": "25MA08134000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Iselin, NJ
• Providers in Iselin, NJ by specialty
• Primary Care Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; 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.