NPIMap

Organization Active NPI

Mountainside Pain Management PC

  • Pain Medicine (Anesthesiology) Physician
  • West Caldwell, NJ
National Provider Identifier
1477017929
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
MOUNTAINSIDE PAIN MANAGEMENT PC
Practice address
185 Fairfield Ave Ste 2a
West Caldwell, NJ 07006-6417
Phone
(973) 226-1230
NPI assigned
Jan 29, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Authorized official

Name
Dr. John Walton Secoy, MDNPI 1023093564
Title
President of Corporation
Phone
(973) 226-1230

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
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

185 Fairfield Ave Ste 2a
West Caldwell, NJ 07006-6417

Mailing address

185 Fairfield Ave Ste 2a
West Caldwell, NJ 07006-6417
Phone (973) 226-1230

Other identifiers 1

IdentifierTypeStateIssuer
725433OtherNJPTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address johnwsecoy@verizon.net Direct

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": "1548720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1477017929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 FAIRFIELD AVE STE 2A",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070066417",
            "telephone_number": "973-226-1230",
            "fax_number": "973-226-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 FAIRFIELD AVE STE 2A",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "070066417",
            "telephone_number": "973-226-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINSIDE PAIN MANAGEMENT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "SECOY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WALTON",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "973-226-1230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "725433",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "johnwsecoy@verizon.net",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Business email",
            "address_1": "185 Fairfield Ave Ste 2A",
            "city": "West Caldwell",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070066417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Caldwell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.