NPIMap

Organization Active NPI

Princeton Healthcare Provider Group LLC

Doing business as Princeton Medicine Specialty Group

  • Internal Medicine Physician
  • Plainsboro, NJ
National Provider Identifier
1699141507
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PRINCETON HEALTHCARE PROVIDER GROUP LLC
Doing business as
Princeton Medicine Specialty Group
Practice address
1 Plainsboro Rd
Plainsboro, NJ 08536-1913
Phone
(609) 853-7885
NPI assigned
Aug 14, 2015
Last updated
Jan 26, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
PRINCETON HEALTHCARE PROVIDER GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Authorized official

Name
Kathryn J Robison, MDNPI 1770517377
Title
President
Phone
(609) 853-7220

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 8

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
Internal Medicine Physician 207R00000X Primary
Cardiovascular Disease Physician 207RC0000X
Maternal & Fetal Medicine Physician 207VM0101X
Obstetrics Physician 207VX0000X
Pediatrics Physician 208000000X
Neurology Physician 2084N0400X
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X

Addresses

Primary practice location

1 Plainsboro Rd
Plainsboro, NJ 08536-1913

Mailing address

4 Princess Rd
Suite 207
Lawrenceville, NJ 08648-2322
Phone (609) 243-0445

Other identifiers 1

IdentifierTypeStateIssuer
0500739MedicaidNJ

Other names 1

  • Princeton Medicine Specialty Group Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other COBIUS HEALTHCARE SOLUTIONS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151228002256 NJ Part B Supplier - Clinic/Group Practice 3173824695 Receives reassigned benefits from 46 practitioners
2 other NPIs on this enrollment
Practice locations: Plainsboro, NJ; Princeton, NJ

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Princeton HLTH Provider GRP4 organizations share this tax ID, including this one
Part of
Princeton HLTH Provider GRP

Other organizations with this tax ID 3

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

Locations

993 Lenox Dr
Ste 207
Lawrenceville, NJ 08648

1 Plainsboro Rd
Fl 6
Plainsboro, NJ 08536
Phone (609) 853-7000

5 Plainsboro Rd
Fl 1
Plainsboro, NJ 08536

5 Plainsboro Rd
Ste 180
Plainsboro, NJ 08536
Phone (215) 829-7297

601 Ewing St
Princeton, NJ 08540
Phone (609) 759-8500

731 Alexander Rd
Ste 202
Princeton, NJ 08540
Phone (609) 921-7456

Practitioners & affiliated clinicians

Practitioners 59

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 59

NPI Registry JSON

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

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611619200000",
    "number": "1699141507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PRINCESS RD",
            "address_2": "SUITE 207",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482322",
            "telephone_number": "609-243-0445",
            "fax_number": "609-844-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PLAINSBORO RD",
            "city": "PLAINSBORO",
            "state": "NJ",
            "postal_code": "085361913",
            "telephone_number": "609-853-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON HEALTHCARE PROVIDER GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRINCETON HEALTHCARE PROVIDER GROUP LLC",
        "enumeration_date": "2015-08-14",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A",
        "authorized_official_last_name": "ROBISON",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-853-7220",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0500739",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "COBIUS HEALTHCARE SOLUTIONS",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Princeton Medicine Specialty Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Princeton Medicine Specialty Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plainsboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.