NPIMap

Organization Active NPI

Performance Medical Group of Hillsborough LLC

  • Pain Medicine (Anesthesiology) Physician
  • Hillsborough, NJ
National Provider Identifier
1487483095
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
PERFORMANCE MEDICAL GROUP OF HILLSBOROUGH LLC
Practice address
105 Raider Blvd Ste 201
Hillsborough, NJ 08844-1528
Phone
(908) 756-2424
NPI assigned
Jul 31, 2024
Last updated
Sep 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Authorized official

Name
Ms. Nicole Hildebrandt
Title
Revenue Cycle Manager
Phone
(908) 756-2424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

105 Raider Blvd Ste 201
Hillsborough, NJ 08844-1528

Mailing address

1011 US Highway 22 Ste 203
Bridgewater, NJ 08807-2979
Phone (908) 756-2424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20241029004391 NJ Part B Supplier - Clinic/Group Practice 5597298596 Receives reassigned benefits from 38 practitioners
Practice locations: Hillsborough, NJ
O20250509000499 NJ DME Supplier - Multi-Specialty - Physician 5597298596 Practice locations: Hillsborough, NJ

National Provider Directory

National Provider Directory

Locations

105 Raider Blvd
Ste 201
Hillsborough, NJ 08844

Practitioners & affiliated clinicians

Practitioners 40

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.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1487483095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 US HIGHWAY 22 STE 203",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072979",
            "telephone_number": "908-756-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 RAIDER BLVD STE 201",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088441528",
            "telephone_number": "908-756-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE MEDICAL GROUP OF HILLSBOROUGH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "HILDEBRANDT",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "908-756-2424",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsborough, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.