Somerset Cosmetic & Reconstructive Surgery, LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

25MA07555400 Issued in NJ

Legal business name

SOMERSET COSMETIC & RECONSTRUCTIVE SURGERY, LLC

Practice address

31 Mountain Blvd.
BLDG T
Warren, NJ 07059-5648

Phone

(908) 222-0070

Fax

(908) 222-8027

NPI assigned

Jun 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Matthew A Clott, M.D.NPI 1801849096

Title

Owner

Phone

(908) 222-0070

Specialties & licenses 1

Addresses

Other identifiers 5

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.

• Matthew Alan Clott, MD

  • Plastic Surgery Physician
  • Warren, NJ
  • NPI 1801849096
  Medicare reassignment Authorized official
• Arunesh Kumar Mishra, M.D.

  • Geriatric Psychiatry Physician
  • Perth Amboy, NJ
  • NPI 1750361671
  NPD (past)

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474243200000",
    "number": "1598700700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 MOUNTAIN BLVD.",
            "address_2": "BLDG T",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070595648",
            "telephone_number": "908-222-0070",
            "fax_number": "908-222-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 MOUNTAIN BLVD.",
            "address_2": "BLDG T",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070595648",
            "telephone_number": "908-222-0070",
            "fax_number": "908-222-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMERSET COSMETIC & RECONSTRUCTIVE SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2016-09-19",
        "status": "A",
        "authorized_official_last_name": "CLOTT",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-222-0070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "NJ",
            "license": "25MA07555400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "J33130",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS",
            "identifier": "MC01512F10",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3106486",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE RR",
            "identifier": "P00166342",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "8219869",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leonard Craig Sitrin, PH.D.
• Jasmine Smith Brown, BCBA
• Lee David Smulen, D.M.D.
• Crystal Socha
• Soft Care Dental Group
• Somerset Hills Residential Treatment Center, Inc.
• Somerset Women'S Care, LLC
• Bhavti Soni
• Lindsey Soper, OTD, OTR/L
• Special Needs Residence

• Plastic Surgery Physician in Warren, NJ
• Providers in Warren, NJ by specialty
• Plastic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.