Individual provider Active NPI

Peyton Rydholm

  • Physician Assistant
  • Long Branch, NJ
National Provider Identifier
1548170236
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
50 Chelsea Ave Unit 406
Long Branch, NJ 07740-8175
Phone
(732) 228-0422
NPI assigned
Sep 8, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

50 Chelsea Ave Unit 406
Long Branch, NJ 07740-8175

Mailing address

50 Chelsea Ave Unit 406
Long Branch, NJ 07740-8175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1548170236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 CHELSEA AVE UNIT 406",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077408175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 CHELSEA AVE UNIT 406",
            "city": "LONG BRANCH",
            "state": "NJ",
            "postal_code": "077408175",
            "telephone_number": "732-228-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYDHOLM",
        "first_name": "PEYTON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-08",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Branch, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.