NPIMap

Organization Active NPI

Pediatric Health, PA

  • Pediatrics Physician
  • Howell, NJ
National Provider Identifier
1609048057
Registry record updated Feb 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA02343600 Issued in NJ
Legal business name
PEDIATRIC HEALTH, PA
Practice address
4200 Route 9 S
Howell, NJ 07731-3316
Phone
(732) 905-5525
Fax
(732) 905-5502
NPI assigned
Mar 26, 2008
Last updated
Feb 16, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2011

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

Authorized official

Name
Roberta Lopez
Title
Comptroller
Phone
(732) 780-3333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 25MA02343600 NJ Primary

Addresses

Primary practice location

4200 Route 9 S
Howell, NJ 07731-3316

Mailing address

69 W Main St
Freehold, NJ 07728-2114
Phone (732) 409-3633

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
31D1081133Advocare Pediatric Health4200 Route 9 South, Howell, NJ 07731AccreditationSep 3, 2027

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Health PA5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

69 W Main St
Freehold, NJ 07728
Phone (732) 409-3633

NPI Registry JSON

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297814400000",
    "number": "1609048057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 W MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282114",
            "telephone_number": "732-409-3633",
            "fax_number": "732-409-7133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 ROUTE 9 S",
            "city": "HOWELL",
            "state": "NJ",
            "postal_code": "077313316",
            "telephone_number": "732-905-5525",
            "fax_number": "732-905-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC HEALTH, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2011-02-16",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_title_or_position": "COMPTROLLER",
        "authorized_official_telephone_number": "732-780-3333"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA02343600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; 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.