Bricktown Medical Group PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

BRICKTOWN MEDICAL GROUP PA

Practice address

34 Lanes Mill Rd
Brick, NJ 08724

Phone

(732) 458-0300

Fax

(732) 458-8449

NPI assigned

Sep 14, 2006

Last updated

Feb 23, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Martin Riss, DONPI 1548276827

Title

President

Phone

(732) 458-0300

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

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.

• Martin Riss, DO

  • Family Medicine Physician
  • Brick, NJ
  • NPI 1548276827
  Medicare reassignment NPD Authorized official
• Lily L Babayev, MD

  • Internal Medicine Physician
  • Brick, NJ
  • NPI 1851307136
  Medicare reassignment

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298419200000",
    "number": "1568567238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 LANES MILL RD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "08724",
            "telephone_number": "732-458-0300",
            "fax_number": "732-458-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 LANES MILL RD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "08724",
            "telephone_number": "732-458-0300",
            "fax_number": "732-458-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRICKTOWN MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2011-02-23",
        "status": "A",
        "authorized_official_last_name": "RISS",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-458-0300",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brick Rheumatology, LLC
• Brick Senior Care, LLC (The Chelsea at Brick)
• Brick Township Endodontics LLC
• Brick Women's Physicians
• Brick Xray LLC
• Bricktowne Pharmacy LLC (Personal Touch Pharmacy)
• Bridges Behavioral Health Care
• Brielle Orthopedics PA
• Robbie Ann Bright-Poole, MS CCCA
• Brigitte Soltesz, D.C.,P.C.

• Internal Medicine Physician in Brick, NJ
• Providers in Brick, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; 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.