NPIMap

Organization Active NPI

Somc Medical Group PC

  • Internal Medicine Physician
  • Jackson, NJ
National Provider Identifier
1699004606
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SOMC MEDICAL GROUP PC
Practice address
2290 W County Line Rd
Jackson, NJ 08527-2267
Phone
(732) 364-3881
NPI assigned
Dec 22, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Authorized official

Name
Carl Marchetti, M.D.
Title
President
Phone
(732) 643-4312

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X NJ Primary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X NJ

Addresses

Primary practice location

2290 W County Line Rd
Jackson, NJ 08527-2267

Mailing address

1200 Jumping Brook Rd
Building 5
Neptune, NJ 07753-2634
Phone (732) 643-4321

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100318000313 NJ Part B Supplier - Clinic/Group Practice 4587799358 Receives reassigned benefits from 39 practitioners
Practice locations: Forked River, NJ; Toms River, NJ; Ship Bottom, NJ; Jackson, NJ; Brick, NJ

National Provider Directory

National Provider Directory

Locations

2211 Route 88
Ste 11
Brick, NJ 08724

701 S Main St
Forked River, NJ 08731
Phone (609) 250-4110

730 Lacey Rd
#G8
Forked River, NJ 08731
Phone (609) 693-2900

27 S Cooks Bridge Rd
Ste 1-5
Jackson, NJ 08527
Phone (732) 370-4222

27 S Cooks Bridge Rd
Ste 2-2
Jackson, NJ 08527
Phone (732) 364-3881

1301 Route 72 W
Ste 300
Manahawkin, NJ 08050
Phone (609) 597-6513

1301 Route 72 W
Ste 340
Manahawkin, NJ 08050
Phone (609) 597-0547

1200 Jumping Brook Rd
Bldg 5
Neptune, NJ 07753
Phone (732) 643-4400

2911 Route 88
Point Pleasant Boro, NJ 08742
Phone (732) 892-8488

9 Mule Rd
Ste 11
Toms River, NJ 08755
Phone (732) 797-1535

9 Mule Rd
Ste 10
Toms River, NJ 08755

Practitioners & affiliated clinicians

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1699004606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 JUMPING BROOK RD",
            "address_2": "BUILDING 5",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077532634",
            "telephone_number": "732-643-4321",
            "fax_number": "732-481-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 W COUNTY LINE RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272267",
            "telephone_number": "732-364-3881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMC MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-22",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "MARCHETTI",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-643-4312",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.