Gastro Specialists LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

25MB05137100 Issued in NJ

Legal business name

GASTRO SPECIALISTS LLC

Practice address

453 Amboy Ave
Woodbridge, NJ 07095-2960

Phone

(732) 634-1221

Fax

(732) 634-1290

NPI assigned

Jul 22, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael T Hymanson, D.O.

Title

Owner

Phone

(732) 634-1221

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619998820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 AMAGANSETT DR",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077511184",
            "telephone_number": "732-634-1221",
            "fax_number": "732-634-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 AMBOY AVE",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070952960",
            "telephone_number": "732-634-1221",
            "fax_number": "732-634-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTRO SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HYMANSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-634-1221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MB05137100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8221901",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Woodbridge, NJ
• Providers in Woodbridge, NJ by specialty
• Gastroenterology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.