NPIMap

Organization Active NPI

SMC Med PA

  • Neurological Surgery Physician
  • Great Meadows, NJ
National Provider Identifier
1457611675
Registry record updated May 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
25MA05562800 Issued in NJ
Legal business name
SMC MED PA
Practice address
61 Marble Hill Rd
Great Meadows, NJ 07838-2314
Phone
(201) 804-2800
Fax
(201) 804-8883
NPI assigned
May 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2012

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

Authorized official

Name
Dr. Paul T. Dierlam, MDNPI 1487679551
Title
Director
Phone
(908) 268-2754

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X 25MA05562800 NJ Primary

Addresses

Primary practice location

61 Marble Hill Rd
Great Meadows, NJ 07838-2314

Mailing address

PO Pox 147
Vienna, NJ 07880
Phone (201) 804-2800

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, 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": "1337644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338336000000",
    "number": "1457611675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO POX 147",
            "city": "VIENNA",
            "state": "NJ",
            "postal_code": "07880",
            "telephone_number": "201-804-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MARBLE HILL RD",
            "city": "GREAT MEADOWS",
            "state": "NJ",
            "postal_code": "078382314",
            "telephone_number": "201-804-2800",
            "fax_number": "201-804-8883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMC MED PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-22",
        "last_updated": "2012-05-30",
        "status": "A",
        "authorized_official_last_name": "DIERLAM",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "908-268-2754",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "NJ",
            "license": "25MA05562800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Meadows, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; 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.