Individual provider Active NPI

Raymond Mark Masterson, M.D.

  • Internal Medicine Physician
  • Sea Girt, NJ
National Provider Identifier
1720074727
Registry record updated Jan 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA03844700 Issued in NJ
Practice address
700 Highway 71
Suite 9
Sea Girt, NJ 08750-2805
Phone
(732) 974-0340
Fax
(732) 974-2854
NPI assigned
Sep 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA03844700 NJ Primary

Addresses

Primary practice location

700 Highway 71
Suite 9
Sea Girt, NJ 08750-2805

Mailing address

700 Highway 71
Suite 9
Sea Girt, NJ 08750-2805
Phone (732) 974-0340

Other identifiers 1

IdentifierTypeStateIssuer
1652907MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA03844700NJMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1127606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1720074727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 HIGHWAY 71",
            "address_2": "SUITE 9",
            "city": "SEA GIRT",
            "state": "NJ",
            "postal_code": "087502805",
            "telephone_number": "732-974-0340",
            "fax_number": "732-974-2854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 HIGHWAY 71",
            "address_2": "SUITE 9",
            "city": "SEA GIRT",
            "state": "NJ",
            "postal_code": "087502805",
            "telephone_number": "732-974-0340",
            "fax_number": "732-974-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERSON",
        "first_name": "RAYMOND",
        "middle_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-25",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA03844700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1652907",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sea Girt, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2016; 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.