Hackettstown Medical P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MB72580 Issued in NJ

Legal business name

HACKETTSTOWN MEDICAL P.C.

Practice address

5 Hastings Square Mall
Schooleys Mountain Road
Hackettstown, NJ 07840-4227

Phone

(908) 979-0050

NPI assigned

Oct 9, 2006

Organization subpart

Yes

Parent organization

PRIMARY CARE PARTNERSAs reported in NPPES

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

Authorized official

Name

Dr. Keri Lynn Ingrassia-Squiers, D.O.NPI 1467465203

Title

President

Phone

(908) 979-0050

Specialties & licenses 1

Addresses

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.

• Keri Lynn Ingrassia-Squiers, DO

  • Internal Medicine Physician
  • Hackettstown, NJ
  • NPI 1467465203
  Authorized official Same address or phone
• Wendelyn Lee Waters, M.D.

  • Family Medicine Physician
  • Hackettstown, NJ
  • NPI 1235207986
  NPD (past)

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390521600000",
    "number": "1578650628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HASTINGS SQUARE MALL",
            "address_2": "SCHOOLEYS MOUNTAIN ROAD",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078404227",
            "telephone_number": "908-979-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 HASTINGS SQUARE MALL",
            "address_2": "SCHOOLEYS MOUNTAIN ROAD",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078404227",
            "telephone_number": "908-979-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKETTSTOWN MEDICAL P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIMARY CARE PARTNERS",
        "enumeration_date": "2006-10-09",
        "last_updated": "2014-01-24",
        "status": "A",
        "authorized_official_last_name": "INGRASSIA-SQUIERS",
        "authorized_official_first_name": "KERI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-979-0050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MB72580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hackettstown Diagnostic Associates LLC (Hackettstown Diagnostic Imaging)
• Hackettstown Emergency Associates
• Hackettstown Emergency Medical Associates LLC
• Hackettstown High School
• Hackettstown Inpatient Medical Associates LLC
• Hackettstown Midwives (Midwives of New Jersey)
• Hackettstown Open MRI
• Hackettstown Orthopaedic Group
• Hackettstown Pediatrics, LLC
• Hackettstown Psychological Services

• Internal Medicine Physician in Hackettstown, NJ
• Providers in Hackettstown, 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 Jan 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.