Organization Active NPI

Premier Bariatric New Jersey PC

  • Specialist
  • Wayne, NJ
National Provider Identifier
1548735145
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PREMIER BARIATRIC NEW JERSEY PC
Practice address
1680 Route 23
Wayne, NJ 07470-7501
Phone
(516) 616-5500
NPI assigned
Oct 10, 2018
Last updated
Jun 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Authorized official

Name
Dr. Shawn GarberNPI 1093743320
Title
President
Phone
(516) 616-5500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

1680 Route 23
Wayne, NJ 07470-7501

Mailing address

125 Mineola Ave Ste 200
Roslyn Heights, NY 11577-2042

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181107000106 NJ Part B Supplier - Clinic/Group Practice 1759635980 Receives reassigned benefits from 54 practitioners
Practice locations: Paramus, NJ; Wayne, NJ; Washington, NJ; Springfield, NJ; Somerset, NJ; Glen Ridge, NJ; Florham Park, NJ; Edison, NJ…

National Provider Directory

National Provider Directory

Locations

1121 Route 22
Ste 203
Bridgewater, NJ 08807
Phone (908) 237-7412

230 Sherman Ave
Fl 2
Glen Ridge, NJ 07028
Phone (973) 750-0104

1 W Ridgewood Ave
Ste G2
Paramus, NJ 07652
Phone (201) 652-1213

120 Cedar Grove Ln
Unit T14
Somerset, NJ 08873

355 US Highway 22 E
Springfield, NJ 07081
Phone (908) 325-3000

1680 Route 23
Wayne, NJ 07470
Phone (800) 633-8446

Practitioners & affiliated clinicians

Practitioners 66

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 66

NPI Registry JSON

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687132800000",
    "number": "1548735145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 MINEOLA AVE STE 200",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 ROUTE 23",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707501",
            "telephone_number": "516-616-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER BARIATRIC NEW JERSEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-10",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A",
        "authorized_official_last_name": "GARBER",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-616-5500",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; 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.