Organization Active NPI

Tertiary Specialists of Practice Associates PA

  • Specialist
  • Morristown, NJ
National Provider Identifier
1477049419
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
TERTIARY SPECIALISTS OF PRACTICE ASSOCIATES PA
Practice address
100 Madison Ave FL 2
Morristown, NJ 07960-6136
Phone
(000) 000-0000
NPI assigned
Jul 2, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Authorized official

Name
Mr. Christopher Herzog
Title
Chief Operating Officer
Phone
(973) 829-4320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

100 Madison Ave FL 2
Morristown, NJ 07960-6136

Mailing address

465 South St Ste 200
Morristown, NJ 07960-6439

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180906000338 NJ Part B Supplier - Clinic/Group Practice 6507116910 Receives reassigned benefits from 7 practitioners
Practice locations: Morristown, NJ

National Provider Directory

National Provider Directory

Locations

100 Madison Ave
Fl 1
Morristown, NJ 07960
Phone (833) 292-2663

100 Madison Ave
#1
Morristown, NJ 07960

100 Madison Ave
#G
Morristown, NJ 07960
Phone (833) 292-2663

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1477049419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 SOUTH ST STE 200",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE FL 2",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606136",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERTIARY SPECIALISTS OF PRACTICE ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-02",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "HERZOG",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "973-829-4320",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; 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.