Organization Active NPI

Medical Specialties of New Jersey PA

  • Infectious Disease Physician
  • Clifton, NJ
National Provider Identifier
1578698700
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MA42491 Issued in NJ
Legal business name
MEDICAL SPECIALTIES OF NEW JERSEY PA
Practice address
842 Clifton Ave
Suite 4
Clifton, NJ 07013-1800
Phone
(973) 777-2440
NPI assigned
Feb 21, 2007
Last updated
Sep 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Authorized official

Name
Dr. Gabriella Antoinette Weiss, MDNPI 1558437251
Title
Owner
Phone
(973) 777-4433

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
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X MA42491 NJ Primary

Addresses

Primary practice location

842 Clifton Ave
Suite 4
Clifton, NJ 07013-1800

Mailing address

842 Clifton Ave
Suite 4
Clifton, NJ 07013-1800
Phone (973) 777-2440

Other identifiers 1

IdentifierTypeStateIssuer
1713001MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081111000036 NJ Part B Supplier - Clinic/Group Practice 0345309035 Receives reassigned benefits from 2 practitioners
Practice locations: Clifton, NJ

National Provider Directory

National Provider Directory

Locations

842 Clifton Ave
Ste 4
Clifton, NJ 07013
Phone (973) 777-2440

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1578698700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 CLIFTON AVE",
            "address_2": "SUITE 4",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131800",
            "telephone_number": "973-777-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "842 CLIFTON AVE",
            "address_2": "SUITE 4",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131800",
            "telephone_number": "973-777-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL SPECIALTIES OF NEW JERSEY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "GABRIELLA",
        "authorized_official_middle_name": "ANTOINETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-777-4433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NJ",
            "license": "MA42491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1713001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.