Organization Active NPI

Ear, Nose and Throat Group of Central New Jersey

  • Otolaryngology Physician
  • Edison, NJ
National Provider Identifier
1629095633
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
EAR, NOSE AND THROAT GROUP OF CENTRAL NEW JERSEY
Practice address
2124 Oak Tree Rd FL 2
Edison, NJ 08820
Phone
(732) 205-1311
Fax
(732) 205-9648
NPI assigned
Jul 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Authorized official

Name
Christine E Kim
Title
Manager
Phone
(732) 205-1311

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X NJ Primary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X D01481300 NJ

Addresses

Primary practice location

2124 Oak Tree Rd FL 2
Edison, NJ 08820

Mailing address

PO Box 250
South Plainfield, NJ 07080-0250
Phone (732) 205-1311

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091027000733 NJ Part B Supplier - Clinic/Group Practice 1355488123 Receives reassigned benefits from 5 practitioners
Practice locations: Edison, NJ

National Provider Directory

National Provider Directory
Tax ID family
Ear Nose and Throat Group of Central New Jersey2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2124 Oak Tree Rd
Ste 208
Edison, NJ 08820

2124 Oak Tree Rd
#2
Edison, NJ 08820

2124 Oak Tree Rd
Edison, NJ 08820
Phone (201) 613-3327

904 Oak Tree Ave
Ste P
South Plainfield, NJ 07080
Phone (908) 205-0632

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1629095633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070800250",
            "telephone_number": "732-205-1311",
            "fax_number": "732-205-9648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 OAK TREE RD FL 2",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "08820",
            "telephone_number": "732-205-1311",
            "fax_number": "732-205-9648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR, NOSE AND THROAT GROUP OF CENTRAL NEW JERSEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "732-205-1311"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": null,
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": "D01481300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.