Reformed Church Ministries to the Aging, the Particular Synod of the M

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

REFORMED CHURCH MINISTRIES TO THE AGING, THE PARTICULAR SYNOD OF THE M

Practice address

1990 State Route 18
Old Bridge, NJ 08857-3771

Phone

(732) 607-9230

Fax

(732) 607-9231

NPI assigned

May 15, 2007

Organization subpart

No

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

Authorized official

Name

Edward Mezic, MDNPI 1437218435

Title

Physician

Phone

(732) 349-3838

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Reformed Church House Staff Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Reformed Church Ministries to the Aging, the Particular Synod of the M

  • Assisted Living Facility
  • Old Bridge, NJ
  • NPI 1780688226

  4587707112

  Same PAC ID

Tax ID family

Reformed Church House Staff3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Reformed Church Ministries to the Aging, the Particular Synod of the M

  • Assisted Living Facility
  • Old Bridge, NJ
  • NPI 1649677824
  NPD tax ID
• Reformed Church Ministries to the Aging, the Particular Synod of the M

  • Assisted Living Facility
  • Old Bridge, NJ
  • NPI 1780688226
  NPD tax ID

Practitioners 2

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

• Edward T Mezic, MD

  • Pulmonary Disease Physician
  • Old Bridge, NJ
  • NPI 1437218435
  Medicare reassignment NPD Authorized official
• Grace Brunner, APN

  • Adult Health Nurse Practitioner
  • Freehold, NJ
  • NPI 1235560285
  Medicare reassignment NPD

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1508072745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1247",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087541247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 STATE ROUTE 18",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088573771",
            "telephone_number": "732-607-9230",
            "fax_number": "732-607-9231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFORMED CHURCH MINISTRIES TO THE AGING, THE PARTICULAR SYNOD OF THE M",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "MEZIC",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "732-349-3838",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4477511",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reformed Church House Staff",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kishore Ratkalkar, MD
• Ravindra Patel MD PA
• Mark Ravinsky
• Rbidc
• Reel Optics LLC
• Reformed Church Ministries to the Aging, the Particular Synod of the M
• Reformed Church Ministries to the Aging, the Particular Synod of the M
• Rehabilitation and Electrodiagnostics Inc
• Nicole Rehorn, R.N
• Rekha Rao MD LLC

• Geriatric Medicine (Family Medicine) Physician in Old Bridge, NJ
• Providers in Old Bridge, NJ by specialty
• Geriatric Medicine (Family Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.