Gary E. Statmore M.D., P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA05862500 Issued in NJ

Legal business name

GARY E. STATMORE M.D., P.A.

Practice address

245 Valley Blvd
Wood Ridge, NJ 07075-1236

Phone

(201) 438-5500

Fax

(201) 438-3363

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Gary E Statmore, M.D.

Title

Owner

Phone

(201) 438-5500

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1689746455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 VALLEY BLVD",
            "city": "WOOD RIDGE",
            "state": "NJ",
            "postal_code": "070751236",
            "telephone_number": "201-438-5500",
            "fax_number": "201-438-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 VALLEY BLVD",
            "city": "WOOD RIDGE",
            "state": "NJ",
            "postal_code": "070751236",
            "telephone_number": "201-438-5500",
            "fax_number": "201-438-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY E. STATMORE M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "STATMORE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-438-5500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA05862500",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NJ",
            "license": "25MA02277200",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.