Mountain Lakes Medical Center, LLC
Organization Active NPI Urgent Care Clinic/Center · Mountain Lakes, NJ
NPI 1457585556 · NPPES record last updated Dec 11, 2013
Key facts
- NPI
- 1457585556
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- License
- 25MA07139700 (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
- Organization subpart
- No
Authorized official
- Name
- Dr. Richard Joseph Schweitzer, MD
- Title
- President
- Phone
- (973) 917-3200
Practitioners 12
-
Andrea Mathews Ramirez, PA-C
-
Keith Strulowitz, APN- NP-C
-
Crystal D Bright, MD
-
Andrea Curran Howell, FNP
-
Bryan Kelly McDonald, FNP-C
-
Billy Joe Pitts Jr., NP-C
-
Jerry Allen Spivey Jr., M.D.
-
Eric J. Zanghi, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090928000768 | NJ | Part B Supplier - Clinic/Group Practice | 1355497694 |
Receives reassigned benefits from 1 practitioner Practice locations: Mountain Lakes, NJ |
National Provider Directory
Locations
180 Legacy Pt
Ste 200
Clayton, GA 30525
Phone (706) 782-3100
815 John Beck Dockins Rd
Rabun Gap, GA 30568
Phone (706) 746-5004
Interoperability endpoints
- https://api.platform.athenahealth.com/2145/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | 25MA07139700 | NJ | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 163185 | Other | NJ | MEDICARE PTAN |
Other providers in Mountain Lakes, NJ
- ML Maxillofacial Surgery
- Kim Mooney
- Morris Speech Therapy Associates, LLC
- Mountain Lakes Family Practice LLC
- Mountain Lakes Integrated Healthcare
- Mountain Lakes Pathology LLC
- Mountain Lakes Premier Dental , LLC
- Mountain Lakes Psychotherapy, LLC
- Mpower Physical Therapy LLC
- MTB First Assist LLC
All providers in Mountain Lakes, NJ · Urgent Care Clinic/Center in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.