Organization Active NPI

Specialty Surgery Anesthesiology, LLC

  • Anesthesiology Physician
  • Brick, NJ
National Provider Identifier
1649409582
Registry record updated Jul 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA04142300 Issued in NJ
Legal business name
SPECIALTY SURGERY ANESTHESIOLOGY, LLC
Practice address
74 Brick Blvd
Brick Pavillion BLDG 3
Brick, NJ 08723-7984
Phone
(732) 262-0700
Fax
(732) 262-0400
NPI assigned
Jul 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2010

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

Authorized official

Name
Michael L Amoroso, MD
Title
President
Phone
(732) 531-7246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X 25MA04142300 NJ Primary

Addresses

Primary practice location

74 Brick Blvd
Brick Pavillion BLDG 3
Brick, NJ 08723-7984

Mailing address

215 Monmouth Rd
Oakhurst, NJ 07755-1540
Phone (732) 531-7246

Other identifiers 1

IdentifierTypeStateIssuer
2058308MedicaidNJ

National Provider Directory

National Provider Directory

Locations

74 Brick Blvd
Bldg 3
Brick, NJ 08723
Phone (732) 262-0700

74 Brick Blvd
Brick, NJ 08723
Phone (201) 803-0202

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279843200000",
    "number": "1649409582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 MONMOUTH RD",
            "city": "OAKHURST",
            "state": "NJ",
            "postal_code": "077551540",
            "telephone_number": "732-531-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 BRICK BLVD",
            "address_2": "BRICK PAVILLION BLDG 3",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087237984",
            "telephone_number": "732-262-0700",
            "fax_number": "732-262-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY SURGERY ANESTHESIOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-14",
        "last_updated": "2010-07-23",
        "status": "A",
        "authorized_official_last_name": "AMOROSO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-531-7246",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA04142300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2058308",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2010; 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.