NPIMap

Organization Active NPI

Mountain Lakes Medical Center, LLC

  • Urgent Care Clinic/Center
  • Mountain Lakes, NJ
National Provider Identifier
1457585556
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
25MA07139700 Issued in NJ
Legal business name
MOUNTAIN LAKES MEDICAL CENTER, LLC
Practice address
100 Route 46 E
Building B, Suite 204
Mountain Lakes, NJ 07046-1745
Phone
(973) 917-3200
Fax
(973) 917-3201
NPI assigned
May 5, 2009
Last updated
Dec 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Authorized official

Name
Dr. Richard Joseph Schweitzer, MDNPI 1194746560
Title
President
Phone
(973) 917-3200

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
Urgent Care Clinic/Center 261QU0200X 25MA07139700 NJ Primary

Addresses

Primary practice location

100 Route 46 E
Building B, Suite 204
Mountain Lakes, NJ 07046-1745

Mailing address

100 Route 46 E
Building B, Suite 204
Mountain Lakes, NJ 07046-1745
Phone (973) 917-3200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090928000768 NJ Part B Supplier - Clinic/Group Practice 1355497694 Receives reassigned benefits from 1 practitioner
Practice locations: Mountain Lakes, NJ

National Provider Directory

National Provider Directory

Locations

102 Conecuh Ave W
Union Springs, AL 36089
Phone (334) 386-0378

100 US Highway 46 E
Ste 204
Mountain Lks, NJ 07046
Phone (973) 917-3200

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2145/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386720000000",
    "number": "1457585556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ROUTE 46 E",
            "address_2": "BUILDING B, SUITE 204",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "070461745",
            "telephone_number": "973-917-3200",
            "fax_number": "973-917-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ROUTE 46 E",
            "address_2": "BUILDING B, SUITE 204",
            "city": "MOUNTAIN LAKES",
            "state": "NJ",
            "postal_code": "070461745",
            "telephone_number": "973-917-3200",
            "fax_number": "973-917-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN LAKES MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-05",
        "last_updated": "2013-12-11",
        "status": "A",
        "authorized_official_last_name": "SCHWEITZER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-917-3200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NJ",
            "license": "25MA07139700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Lakes, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; 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.