NPIMap

Organization Active NPI

Rutgers Health-RWJ Scleroderma Program

  • Allergy & Immunology (Internal Medicine) Physician
  • New Brunswick, NJ
National Provider Identifier
1679655781
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology (Internal Medicine) PhysicianTaxonomy code 207RA0201X
Legal business name
RUTGERS HEALTH-RWJ SCLERODERMA PROGRAM
Practice address
125 Paterson St
Suite 5100
New Brunswick, NJ 08901-1962
Phone
(732) 235-7069
Fax
(732) 235-7951
NPI assigned
Oct 19, 2006
Last updated
Jan 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Authorized official

Name
Brenda Lawrence
Title
Director of Revenue Cycle
Phone
(732) 235-6070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology (Internal Medicine) Physician 207RA0201X NU Primary

Addresses

Primary practice location

125 Paterson St
Suite 5100
New Brunswick, NJ 08901-1962

Mailing address

66 West Gilbert St
Red Bank, NJ 07701
Phone (732) 212-0051

Other identifiers 1

IdentifierTypeStateIssuer
3385205MedicaidNJ

Other names 1

  • Rutgers Health RWJ- Allergy Faculty Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050502000326 NJ Part B Supplier - Clinic/Group Practice 5193764991 Receives reassigned benefits from 667 practitioners
38 other NPIs on this enrollment
Practice locations: New Brunswick, NJ; North Brunswick, NJ; Perth Amboy, NJ; Piscataway, NJ; Somerset, NJ; Somerville, NJ; Toms River, NJ; East Brunswick, NJ…

Other NPIs on the same Medicare enrollment 38

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 38

National Provider Directory

National Provider Directory
Tax ID family
Rutgers Health - RWJ Clinical Genetics27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Locations

125 Paterson St
Ste 3100
New Brunswick, NJ 08901
Phone (732) 235-6631

195 Little Albany St
Ste 2800
New Brunswick, NJ 08901
Phone (732) 235-2465

Practitioners & affiliated clinicians

Practitioners 675

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.

View all 675

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610928000000",
    "number": "1679655781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 WEST GILBERT ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "07701",
            "telephone_number": "732-212-0051",
            "fax_number": "732-212-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PATERSON ST",
            "address_2": "SUITE 5100",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011962",
            "telephone_number": "732-235-7069",
            "fax_number": "732-235-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTGERS HEALTH-RWJ SCLERODERMA PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "732-235-6070"
    },
    "taxonomies": [
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3385205",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rutgers Health RWJ- Allergy Faculty",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; 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.