NPIMap

Organization Active NPI

NJ Shore Hospitalists LLC

  • Hospitalist Physician
  • Freehold, NJ
National Provider Identifier
1528618055
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
NJ SHORE HOSPITALISTS LLC
Practice address
901 West Main Street
#307, BLDG B
Freehold, NJ 07728
Phone
(732) 428-7025
NPI assigned
Sep 17, 2019
Last updated
Jan 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Authorized official

Name
Linda L Baxendale
Title
Director, Physician Services
Phone
(732) 428-7025

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Hospitalist Physician 208M00000X NU Primary

Addresses

Primary practice location

901 West Main Street
#307, BLDG B
Freehold, NJ 07728

Mailing address

901 West Main Street
#307, BLDG B
Freehold, NJ 07728
Phone (732) 428-7025

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200102001280 NJ Part B Supplier - Clinic/Group Practice 1557795382 Receives reassigned benefits from 5 practitioners
Practice locations: Freehold, NJ; Long Branch, NJ; Tinton Falls, NJ

National Provider Directory

National Provider Directory

Locations

1001 W Main St
Ste C
Freehold, NJ 07728
Phone (732) 428-7025

1016 Highway 33
Freehold, NJ 07728

Practitioners & affiliated clinicians

Practitioners 5

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": "1568678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1528618055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WEST MAIN STREET",
            "address_2": "#307, BLDG B",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "07728",
            "telephone_number": "732-428-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WEST MAIN STREET",
            "address_2": "#307, BLDG B",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "07728",
            "telephone_number": "732-428-7025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NJ SHORE HOSPITALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-17",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "BAXENDALE",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR, PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "732-428-7025"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.