Active NPI
Garth Hadden Ballantyne, MD
- Surgery Physician
- Hackensack, NJ
National Provider Identifier
1467409573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 26835
- Practice address
- 20 Prospect Ave
Suite 901
Hackensack, NJ 07601-1997 - Phone
- (201) 996-2959
- Fax
- (201) 996-3222
- NPI assigned
- May 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA65505 | NJ | |
| Surgery Physician | 208600000X | 26835 | CT | Primary |
Addresses
Primary practice location
20 Prospect Ave
Suite 901
Hackensack, NJ 07601-1997
Mailing address
20 Prospect Ave
Suite 901
Hackensack, NJ 07601-1997
Phone (201) 996-2959
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26835 | CT | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| L&M Physician Association, Inc | Surgery | Past | Accepting new patients |
| Associated Specialists of Southeastern Connecticut, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- New London, CT
- NPI 1588844591
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444953600000",
"number": "1467409573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 PROSPECT AVE",
"address_2": "SUITE 901",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076011997",
"telephone_number": "201-996-2959",
"fax_number": "201-996-3222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 PROSPECT AVE",
"address_2": "SUITE 901",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076011997",
"telephone_number": "201-996-2959",
"fax_number": "201-996-3222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALLANTYNE",
"first_name": "GARTH",
"middle_name": "HADDEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-27",
"last_updated": "2015-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NJ",
"license": "MA65505",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CT",
"license": "26835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.