NPIMap

Organization Active NPI

Summit Medical Group PA

  • Urgent Care Clinic/Center
  • Brick, NJ
National Provider Identifier
1558055533
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
SUMMIT MEDICAL GROUP PA
Practice address
856 Route 70
Brick, NJ 08724-2977
Phone
(732) 226-8581
Fax
(908) 382-1773
NPI assigned
Jun 5, 2023
Organization subpart
Yes
Parent organization
SUMMIT MEDICAL GROUP PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Authorized official

Name
Jeffrey D Lebenger
Title
Ceo
Phone
(908) 790-6567

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

856 Route 70
Brick, NJ 08724-2977

Mailing address

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 588-3635

Other names 1

  • CityMD Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Summit Medial Group PA84 organizations share this tax ID, including this one
Part of
Summit Medial Group PA

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2285351Summit Medical Group PA856 Route 70, Brick, NJ 08724Certificate of waiverJul 10, 2027

NPI Registry JSON

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1558055533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-588-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 ROUTE 70",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087242977",
            "telephone_number": "732-226-8581",
            "fax_number": "908-382-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMIT MEDICAL GROUP PA",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "LEBENGER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "908-790-6567"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CityMD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.