NPIMap

Organization Active NPI

St. Luke's Warren Physician Group, PC

  • Gynecologic Oncology Physician
  • Phillipsburg, NJ
National Provider Identifier
1679847396
Registry record updated Feb 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
Legal business name
ST. LUKE'S WARREN PHYSICIAN GROUP, PC
Practice address
755 Memorial Pkwy
Suite 106
Phillipsburg, NJ 08865-2748
Phone
(908) 454-5221
Fax
(908) 454-5228
NPI assigned
Feb 27, 2012
Last updated
Feb 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2012

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

Authorized official

Name
Gerard J Delmonico, MDNPI 1184683690
Title
President
Phone
(908) 859-6568

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X NU Primary

Addresses

Primary practice location

755 Memorial Pkwy
Suite 106
Phillipsburg, NJ 08865-2748

Mailing address

10 Brass Castle Rd
Washington, NJ 07882-6309
Phone (908) 835-1910

Other identifiers 1

IdentifierTypeStateIssuer
6285708MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323000967 NJ Part B Supplier - Clinic/Group Practice 9739093675 Receives reassigned benefits from 216 practitioners
13 other NPIs on this enrollment
Practice locations: Phillipsburg, NJ; Washington, NJ; Hampton, NJ

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 216

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 216

NPI Registry JSON

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330300800000",
    "number": "1679847396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BRASS CASTLE RD",
            "city": "WASHINGTON",
            "state": "NJ",
            "postal_code": "078826309",
            "telephone_number": "908-835-1910",
            "fax_number": "908-835-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 MEMORIAL PKWY",
            "address_2": "SUITE 106",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652748",
            "telephone_number": "908-454-5221",
            "fax_number": "908-454-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S WARREN PHYSICIAN GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-27",
        "last_updated": "2012-02-27",
        "status": "A",
        "authorized_official_last_name": "DELMONICO",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-859-6568",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6285708",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillipsburg, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; 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.