Prospect Medical Office, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PROSPECT MEDICAL OFFICE, LLC

Practice address

301 Godwin Ave
Midland Park, NJ 07432-1544

Phone

(201) 444-4526

Fax

(201) 689-0638

NPI assigned

Oct 16, 2006

Organization subpart

No

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

Authorized official

Name

Susan Terek

Title

Practice Administrator

Phone

(201) 444-4530

Specialties & licenses 1

Addresses

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Prospect Medical Office, LLC

  • Specialist
  • Midland Park, NJ
  • NPI 1316198922
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adam D Jarrett, M.D.

  • Internal Medicine Physician
  • Ogdensburg, NY
  • NPI 1952337859
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354838400000",
    "number": "1609956556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 GODWIN AVE",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321544",
            "telephone_number": "201-444-4526",
            "fax_number": "201-689-0638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 GODWIN AVE",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321544",
            "telephone_number": "201-444-4526",
            "fax_number": "201-689-0638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPECT MEDICAL OFFICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2012-12-07",
        "status": "A",
        "authorized_official_last_name": "TEREK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "201-444-4530"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Poole, LMHC
• Laura Theresa Porcaro, LCSW
• Karola Prinz, M.D.
• Professional Sports Care Management Inc
• Prospect Medical Office, LLC
• Quest Autism Programs Inc.
• Raise the Bar Physical Therapy PC
• Mario Edward Ramos, DMD
• Mary Rebecca Fairbanks Rasor, COTA/L
• Erica L. Realpe, LMFT

• Internal Medicine Physician in Midland Park, NJ
• Providers in Midland Park, 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 Dec 7, 2012; 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.