NPIMap

Organization Active NPI

Dr JM LLC

  • Exclusive Provider Organization
  • Brick, NJ
National Provider Identifier
1659601789
Registry record updated Jan 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
25MA06682500 Issued in NJ
Legal business name
DR JM LLC
Practice address
525 Route 70 East
Suite 1-C
Brick, NJ 08723-4022
Phone
(732) 279-6537
Fax
(732) 279-6542
NPI assigned
Jan 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2010

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

Authorized official

Name
Jerry MabagosNPI 1164458451
Title
Owner
Phone
(732) 279-6537

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 25MA06682500 NJ Primary
Health Maintenance Organization 302R00000X 25MA06682500 NJ
Preferred Provider Organization 305R00000X 25MA06682500 NJ
Point of Service 305S00000X 25MA06682500 NJ

Addresses

Primary practice location

525 Route 70 East
Suite 1-C
Brick, NJ 08723-4022

Mailing address

525 Route 70 East
Suite 1-C
Brick, NJ 08723-4022
Phone (732) 279-6537

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263340800000",
    "number": "1659601789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 ROUTE 70 EAST",
            "address_2": "SUITE 1-C",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087234022",
            "telephone_number": "732-279-6537",
            "fax_number": "732-279-6542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 ROUTE 70 EAST",
            "address_2": "SUITE 1-C",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087234022",
            "telephone_number": "732-279-6537",
            "fax_number": "732-279-6542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-13",
        "last_updated": "2010-01-13",
        "status": "A",
        "authorized_official_last_name": "MABAGOS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-279-6537"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NJ",
            "license": "25MA06682500",
            "primary": true
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NJ",
            "license": "25MA06682500",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NJ",
            "license": "25MA06682500",
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "NJ",
            "license": "25MA06682500",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jan 13, 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.